Background The Transforming End of Life Care in the Community Programme was based on the success of the Transform Acute Hospitals programme. Both programmes aim to promote multi-professional team communication and to improve end of life care. Two local Clinical Commissioning Groups provided funding for the community programme, which launched in April 2015, following introduction of the programme to health-professionals by means of masterclasses.
Aim The hospital programme aims to accommodate patients going back to their preferred place of care/death. The community programme aims to keep people in their preferred place of care/death. It intends to promote the use of supportive care registers and improve the incidence, quality and recording of future wishes, preferences, wishes and values – Advance Care Planning (ACP).
Jointly, both programmes are facilitating implementation of the new Electronic Palliative Care Co-ordination System.
Methods The hospital programme utilises teaching time with hospital staff. In the community, Protected Education Training time in GP practices is used, incorporating district nursing teams.
Training covers ACP, DNACPR and end-of-life care, and has extended to community therapy teams and nursing/care homes, with stand-alone sessions for NWAS and PTS. It incorporates the ‘One Chance to Get it Right’ and the ‘NICE Guidance for the Care of the Dying Adult’ documents. The education is measured with both pre and post impact and evaluation.
Results The number of people trained as of 31/03/16 is 628. Completed figures from cohort one indicate a 56% increase in the number of people identified as being in their last year of life. Records of ACP and DNACPR discussions have increased by almost 21%.
In 2008, average local DiUPR figures were 33.8% (England 37.8%). In 2014, these figures were 39.2% and 44.7% respectively. We wait to see whether this education initiative, in combination with other aspects of local strategy will lead to a further improvement in DiUPR.
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