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Abstract
The hospice was approached by a Clinical Commissioning Group (CCG) to run a pilot project supporting people in their normal place of residence at end of life.
The CCG felt that too many people were being admitted to hospital and that there were delays in discharge due to lack of co-ordination and personal care.
The aim of this service was to enable people to: die in their preferred place of care; enable rapid discharge from acute care to preferred place of care; avoid unnecessary admission to acute care; provide support to carers/families.
This community service was developed to enhance services already available to support people at end of life.
Method A small team was recruited to deliver this service: one band 6 RN to assess, plan care and co-ordinate the service (Monday to Friday 9 am − 5 pm)
Availability of HCAs to deliver personal care from 8 am-8 pm, 7 days a week
Referrals were made via the hospice assessment and coordination team.
People were managed by this service for a maximum of 5 days, then discharged on to the most appropriate hospice/external service for ongoing support
Detailed results were kept and reported on.
Results
99 people were supported in nine months
31 died under the care of the service
12 were admitted into the hospice
56 hospital admissions were avoided
53 were referred on to the hospice Community Clinical Nurse Specialist Team
two were admitted to hospital
Only three people needed personal care.
Conclusion The project supported people to die where they wished to be cared for. It prevented a number of hospital admissions due to the rapid and skilled support of trained staff. The care component was not needed as the present provider was able to support within an appropriate timeframe. Feedback from families and carers was overwhelmingly positive.