Article Text

Download PDFPDF

P-13 Creating equality in end-of-life domiciliary care at home across Cheshire
  1. Sarah Dale
  1. East Cheshire Hospice, Macclesfield, UK


Background Due to disparity in commissioned end-of-life domiciliary care at home, poor communication and the variation of the quality of care being delivered, the collaboration project’s aim was to improve service delivery, patient experience and reduce unwanted admissions during the final months of life.

As a consequence of this fragmented approach, there is duplication of commissioned services. The Continuing Health Care [CHC] model uses multiple independent care providers, at varying costs, and is dependent on availability at the time of request (NHS CHC Strategic Improvement Programme [Internet] Accessed 04 May 2022).

The proposal for commissioning change identified the need for a consistent approach to delivering high level patient outcomes from this service across Cheshire. All the partner organisations involved worked together to support the patients’ full provision of home care packages within the remit of the CHC fast track criteria, including out of hours support, night care, pre- and post- bereavement support for both patients and their primary carers and ongoing review of the service.

The aim of the collaboration between NHS services and third sector organisations was to support people whose Preferred Place of Care and Death [PPC/D] is their own home and who require a planned or urgent package of care to enable this to happen (Leadership Alliance for the Care of Dying People, 2014; Ambitions for Palliative and End of Life Care, 2021).

The three Partnership Hubs now provide a rapid, planned and unplanned care response, which is supported by a single point of access, delivering a consistent step up and step down care model across all Cheshire localities.

Results Results in first month (patients referred):

  • 100% recorded on GSF and local palliative register.

  • 100% completed advance care planning.

  • 100% patients care facilitated within 48hours of referral.

  • 88.9% patients achieving their PPD.

Conclusion This new way of working provides significant opportunity to reshape existing services and to strengthen integration and coordination. The integration of services allows for shared learning, service sustainability and the opportunity for further future developments, linking into emerging programmes such as Place-based care and the Digital First agenda.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.