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013 Co-ordinated and Cost-effective Health and Social Care at the End of Life - The Responsibility of Hospices
  1. Nigel Hartley
  1. St Christopher’s Group, London, UK


Any future model of end of life care delivery in the UK needs increased and more effective partnership working between health and social care agencies. The 2008 Department of Health’s End of Life Care Strategy recognised that a cultural shift in attitude within the health and social care workforce is required, and an NAO report (2008) suggested a need for greater input from social care to address ongoing challenges. The 2011 publication from the Palliative Care Funding Review and the Report of the Commission on Funding of Care and Support recommends that there should be better integrated health and social care for those facing the end of life, and that this should be free at the point of delivery. This presentation tracks the development of a new Social Care service by a large UK hospice in partnership with a number of key community providers and commissioners. A number of different models of service delivery which have been developed alongside each other are presented, focussing on three areas:

  1. developing a referral process and assessment procedures, as well as delivering personal care packages for people in the last year of life on the locality end of life register.

  2. developing short term personal care packages enabling people to be rapidly discharged from hospital.

  3. developing a hospice-based co-ordination centre where people’s health and social care needs are integrated more successfully and cost-effectively.

Outcomes utilising a range of tools and measures will be presented and an argument will be made that hospices not only have a responsibility, but also the relevant expertise and experience to develop, present and market themselves as end of life care co-ordination ‘hubs’ taking on responsibility for leading on the provision of integrated health and social care to people within the last year of life.

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