Background Farleigh Hospice provides palliative and end-of-life (EoL) care to the people of Mid Essex (population ~400k) including fast track support services. It operated a traditional hospice model of care with a dedicated Inpatient Unit (IPU) and community services i.e. day therapies, CNS team, and domiciliary care etc., which were not closely aligned.
The problem During the first wave of the pandemic it became apparent that the current service model was not viable. Clinical vacancies existed in both community and inpatient services and were significantly exacerbated by shielding guidelines and the loss of ‘patient facing’ staff.
In March 2020 the Farleigh clinical services were reorganised as part of an emergency COVID-19 resilience plan
Three multidisciplinary ‘Locality Care Teams (LCTs)’ were created and aligned to local Primary Care Networks (PCNs)
Each locality provided oversight of all clinical services in their geographical area ranging from specialist to domiciliary care.
The IPU was closed and all staff were redeployed to the LCTs to maximise the community effort.
Non-clinical members of staff were ‘upskilled’ and redeployed into the community teams.
Outcomes Between April and September 2020, we cared for over 1300 patients (a 28% increase on the same period last year) with a 21% increase in referrals. Near 90% of PDD was achieved during this period, the majority dying at home. A successful reorganisation of clinical services in September 2020 solidified the new clinical model.
At a time when many hospices were concentrating on inpatient services, our hospice took the bold step to mobilise all the workforce to support the community locality teams and care for more people in their own homes.
The use of COVID-19 as a catalyst for organisational change to create multidisciplinary community teams aligned to PCNs.
The need for a transformation phase post reorganisation in order to firm up processes and systems.
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