Background The North Manchester Palliative Care Support Service (MMSPCSNL) was introduced in April 2016 with a significant remodelling of the previous provision. The service expanded local capacity and transformed the quality and experience of supportive and palliative care Some patients were identified as being not in need of specialist hospice beds or acute hospital admission but had non-complex requirements that could not be met in their ordinary home environment. A single bed within an Intermediate Care Unit was made available to support this care.
Methods Patients with non-complex needs are considered for admission to this bed if they are known to the MMSPCSNL and assessed by a band 7 clinician or doctor within the team at time of need. The bed is not suitable for individuals with complex needs or requiring daily medical review/input. During their admission they are supported by the staff within the unit as for any other inpatient in addition to regular review by the specialist palliative care team.
Results Since the pilot commenced, the skills and experience of the staff in the unit has increased with admission of patients with varying needs. The utilisation of the bed has been for multiple reasons from rehabilitation following cancer treatment in acute hospitals, to social crisis admissions, non-complex end of life care and for combined reasons. During the first 12 months of the pilot 8 patients were supported with an admission length ranging from 12 to 65 days. 6 were discharged, 2 died in the compassionate bed as their preferred place of care.
Conclusion This pilot has achieved multiple positive outcomes such as appropriate care for patients in social crisis preventing acute hospital admissions, enhanced skills for unit staff and flexibility of approach with all teams involved. Funding is ongoing - the pilot has received favourable results and comments.
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