Background The hospice is based in a large urban community with a diverse population. Traditional hospice CNS first assessment was in the person’s home. The hospice designed a primary care clinic pilot based in GP surgeries to work alongside this model.
Increase referrals from low- referring communities
Provide choice of service in the patients’ locality
Provide efficiencies in CNS working in mileage and time.
Engagement with communities, referrers and primary care to scope and design the model with continued engagement
Three×weekly clinics piloted; two in GP Practice and one at the hospice, all in areas with diverse demography
Referrals assessed as appropriate for clinic at first contact
Mobile working enabled on remote site
Use of IPOS for assessment and follow up.
How do we measure outcomes?
Patient experience questionnaires
Use of integrated palliative care outcome scale (IPOS) for assessment and monitoring
A steering group of GP, patient representative, clinical leads and fundraising monitor progress and outcomes
71 new patients seen across three clinics in 10 months
94 follow- up appointments
165 total consultations at clinic.
ResultsThis is approximately 8% of total caseload.
Mileage costs and time are reduced. Mobile IT enables efficiencies and access to records. Clinics have created choice for those who do not wish to be seen at home. The hospice clinic has created an opportunity to experience the hospice environment. Complex holistic care can be managed in a clinic setting. Questionnaire feedback demonstrates; appreciation of choice and improved quality of life.
’ We are feeling more positive with the future and understand that we are not alone. Thank you’
Conclusion CNS Outpatient clinics can lead to efficiencies in CNS working and improved primary care relationships. Clinics are a useful option to have alongside usual home assessment. Future plans are to increase clinic sites and develop integrated team working at sites.
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