Agenda item

(To receive a report from Chris Wheway (Chief Executive – St Barnabas Hospice Trust) which provides the Committee with an update on Palliative and End of Life Care which has been delivered by St Barnabas Hospice Trust since 1979 to improve end of life care for the people of Lincolnshire.  Chris Wheway (Chief Executive – St Barnabas Hospice Trust), Jane Bake (Director of Service Innovation and Integration – St Barnabas Hospice Trust) and Michelle Webb (Director of Patient Care – St Barnabas Hospice Trust) will be in attendance for this item)

A report by Chris Wheway (Chief Executive – St Barnabas Hospice Trust) was considered which provided an update on Palliative and End of Life Care which had been delivered by St Barnabas Hospice Trust since 1979 to improve end of life care for the people of Lincolnshire.

Chris Wheway (Chief Executive – St Barnabas Hospice Trust) and Michelle Webb (Director of Patient Care – St Barnabas Hospice Trust) were in attendance for this item.

The Chairman asked that an update be given following the fire at Grantham Hospital on 19 April 2016 where some patients in the "Hospice in a Hospital" were affected.

It was confirmed that the fire took place on the corridor where the Hospice in a Hospital was situated.  Patients had been moved to where there was capacity, with two patients being repatriated to Nettleham Road, one placed at home and another preparing to be discharged to home.  The ward team were working with the site lead to look at provision of extra community capacity.  Should any further admissions come forth, it was confirmed that the Tulip Suite in Spalding had palliative beds available.  Each case would be dealt with on an individual basis as it was personal preference for this type of care.

The Chairman gave thanks for the update and moved on to the report as presented.

The Committee was advised that the palliative and end of life care sought to improve the quality of life for patients with life limiting conditions and the Trust continued to be committed to that by working in partnership with other health and social care providers.

The organisation was also actively engaged in the Lincolnshire Health and Care development programme through neighbourhood team working and at senior level through established partnerships.

A definition of palliative care was provided:-

·       Provides relief from pain and other distressing symptoms;

·       Affirms life and regards dying as a normal process;

·       Intends neither to hasten or postpone death;

·       Integrates the psychological and spiritual aspects of patient care;

·       Offers a support system to help patients live as actively as possible until death;

·       Offers a support system to help the family cope during the patient's illness and in their own bereavement;

·       Uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;

·       Will enhance quality of life and may also positively influence the course of illness;

·       Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy; and includes those investigations needed to better understand and manage distressing clinical complications.

Nationally, over the next ten years, the incidence of cancer was projected to rise by 30% in men and 12% in women and, in addition, dementia and chronic illnesses linked to lifestyle would also increase.  By 2021, it was estimated that over one million people in the UK would be living with dementia.

St Barnabas Hospice was a countywide organisation which recognised the differing demographic and health challenges faced by communities within Lincolnshire, in particular the ageing population and long-term health needs of those on the east coast.

Services provided by St Barnabas Hospice included:-

·       Palliative Care Coordination Centre;

·       Hospice at Home;

·       Inpatient Unit;

·       Day Therapy;

·       Welfare Service;

·       Family Support Service;

·       Hospice in the Hospital (a partnership initiative);

The Committee were particularly referred to the ambitions of St Barnabas Hospice for palliative and end of life care as the Trust were keen to have these implemented wherever possible:-

·       Each person is seen as an individual and care is goal orientated and person-centred;

·       There is fair access to care, irrespective of diagnosis or place of residence;

·       Comfort, wellbeing and control are maximised taking a rehabilitative palliative care approach to self-management and empowerment, enabling people to maintain their independence and to live until they die;

·       The care provided is integrated and coordinated, staff work with other providers to ensure the patient receives the right care at the right time from the right person in a timely manner; and

·       Care is delivered by well-trained, skilled, supported and resilient multi-professional teams.

Members were given the opportunity to ask questions, during which the following points were noted:-

·       The Trust was pleased to have been included within the discussions regarding the Lincolnshire Health and Care programme development as it was often thought that the voice of smaller organisations could be lost amongst a number of large, acute, organisations;

·       The Committee were extremely supportive of the care and support provided by St Barnabas Hospice and suggested that wider advertising would help to ensure people were aware of the services available;

·       Specialist palliative care services provided by St Barnabas could support care homes.  Nursing homes would be able to provide end of life care with their own registered staff but specialist care could be provided by St Barnabas also;

·       A "wrapper system" was in place which picked up patients known to St Barnabas when admitted to the acute trust.  Nurses would then be alerted using a flagging system who would then intervene to try and place the patient in their own home with the specialist care needed;

At 2.45pm Councillor Mrs S M Wray left and did not return.

·       Should a patient be admitted to an acute hospital for treatment not provided by St Barnabas, it was confirmed that it was the responsibility of the acute trust to advise St Barnabas of the admission;

·       If the patient was unknown to St Barnabas at the time of admission to an acute hospital, the eligibility of that patient for services provided by St Barnabas was the decision of the admitting clinician;

·       A Matron had recently been appointed, to commence at the beginning of May 2016, for outreach to support all clinicians in identifying palliative patients or those approaching end of life care.  The role was funded by St Barnabas and was a full-time position;

·       A huge amount of work was undertaken with dementia care and palliative care.  It was confirmed that a dementia diagnosis was actually an end of life diagnosis although very different to a cancer diagnosis.  Early discussions would be required to ensure that the person received the care that they both wanted and needed.  Work of this type was undertaken alongside Lincolnshire Partnership NHS Foundation Trust and was working well;

·       It was suggested that more information on the role of volunteers and what might be expected of them may increase the numbers coming forward;

·       MacMillan did provide some funding in addition to procuring MacMillan grants for people.  MacMillan fund a nursing post for a maximum of two years but there was an expectation that they would then be funded by the host organisation but continue to be referred to as MacMillan nurses;

·       There were a mixture of private and Adult Social Care packages available.  It was difficult to recruit staff in smaller rural areas which provided greater difficulty in providing complex care packages in those areas.  As a result, staff were often recruited to support workers on a zero hours contract but this resulted in a difficulty in maintaining continuity of care; and

·       The Trust supported the Cavendish Care Training Certificate and recruited health care support workers with NVQ qualifications in direct care.  Those with an NVQ in direct care could be supported through the Care Certificate.

RESOLVED

1.    That the report and comments be noted; and

2.    That a further update be provided in early 2017.

At 3.00pm, Councillor S L W Palmer left and did not return.