Background In November 2016 the in-patient unit (IPU) was temporarily closed and relocated to a nursing home to allow essential demolition work. This meant a reduction from 12 to 5 IPU beds. An Enhanced Hospice at Home (EHAH) service was developed to mirror the care we deliver in IPU and support the reduction in beds.
Aim Our organisation wanted to ensure that patients’ needs and wishes continued to be met. To enable this, the service supports four patients in their own home environment for end of life care or complex symptom control issues. It is enabling us to bring our in-patient care out into the community.
Methods A team of experienced registered nurses and health care assistants offer up to four visits a day to provide personal care, symptom management and emotional support. Specialist hospice doctors provide daily visits depending on the patient’s clinical needs. Care in the community still involves our wider multidisciplinary team including therapists, family support and benefit advice.
Results During the project data has shown 93% of patients’ PPDs that have been home have been met. Combined IPU and EHAH admissions are higher than previous IPU admissions alone. Staff costs have been unchanged by splitting the service.
Feedback Includes ‘I felt the team were excellent and it was obvious they were very experienced as they knew exactly how to advise myself and my brother with all aspect of our mother’s care.’
‘My family felt the care we received was invaluable, it enabled my husband to pass from this world with dignity. It would be wonderful to think that all people could receive this special care in the last days of their lives.’
Conclusion This EHAH has not only helped us provide holistic specialist care to our patients and families but it has also given us the opportunity to build working relationships with GPs and district nurses and be able to share our knowledge and skills.