Background Service inequity identified within palliative care community services and access to inpatient unit beds across the locality.
Palliative care referrals were triaged through each organisation. This often resulted in multiple referrals for each person to multiple organisations and service providers.
GP population 610,000 people; 72 surgeries. Clinical Commissioning Group (CCG) – commissioners.
Aims The ‘Ambitions for Palliative and End of Life Care’ include: ‘Care is coordinated’; ‘each person gets fair access to care’ and ’each person is seen as an individual’ (National Palliative and End of Life Care Partnership, 2015).
Specialist Palliative Care (SPC) providers and CCG worked together implementing single point referral to:
Provide equitable access to services across the locality;
Reduce duplication of referrals to multiple services;
Increase access to SPC;
Improve timely intervention on referral;
Ensure patient wishes recorded: Electronic Palliative Care Co–ordination System (EPaCCs).
Priority tool and response times;
Agreed monthly data collection and reporting;
Management of EPaCCs data;
2–year CCG funding – set up, admin costs;
Agreed resources from each organisation providing 5–day nurse triage cover;
One agreed host centre;
Community service lead meetings;
Commissioned report at end of 18–month period;
Online professionals survey feedback;
Staff interviews – working within or managing service feedback.
Results Report findings (18-month evaluation report):
Monthly average – 255 referrals;
Systems and processes reported more streamlined;
Greater awareness of services across providers;
26.8% monthly average referrals were P1 & P2 (Emergency/Urgent);
72.6% monthly average referrals were P3 & P4 (Responsive/Planned).
Conclusion Evaluation data and feedback demonstrated benefits to patients, referrers and increased awareness of services. Single point of referral enabled accurate data gathering and efficient use of service resources.
Demonstrated effective collaborative working. We learnt increased GP awareness across the locality may increase earlier referrals and clear feedback was required to referrers regarding priority of triage.
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