East Sussex Healthcare Trust (ESHT) is a combined community/ acute hospital trust, with two acute hospitals 20 miles apart and 100 000 admissions a year. In light of workforce changes, the need for joint working across hospital teams and CQC inspection results, a new Supportive and Palliative Care service (SPC) was developed to improve care delivered.
Methods An away day with key stakeholders was organised Dec 2016 to highlight needs of future service and standardise working practices between members of palliative care and EOLC team's cross-site. Both teams amalgamated to become Supportive and Palliative Care Team (CNSs, PDNs, consultants and a specialty doctor). A new nurse team leader role was created and medical clinical lead appointed. Clear unified SPC referral guidelines were developed with one referral point of contact mobile number on each site being used. A standardised cross-site operating procedure was developed. Video conferenced weekly MDT meetings are held cross-site.
An awareness campaign, including newsletter and team information sheet has been developed. The team are involved in multidisciplinary teaching delivery and regular team and governance meetings. Team KPI's are presented to the Trust EOLC steering group. An online staff feedback survey has been developed and will go out to all staff to influence team development (results to follow).
Results From January – September 2017 there's been a 63% increase in referrals to one site, with a 30% increase cross-site. 90% of patients are seen within 24-hours of referral with 60% reviewed same day. 30% of the caseload is non-malignant, a 10% increase. The team supports all patients identified as being in their last days of life on an individualised care plan (fully embedded in practice).
Conclusion There has been an improvement in cross-site hospital team working. Staff feedback on the team will further influence team development.
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