Palliative Care in Derbyshire has just become stronger as DHU Healthcare has developed two essential new services to work with their Palliative Care Urgent Response Service (PCURS).
The PCURS provides urgent treatment at home to patients who are on end-of-life care, reducing the chances of them having to go to hospital in an emergency, enabling them to die in comfort, in their own environment surrounded by their loved ones.
Thanks to additional funding from Hospice UK and NHS England, the service is now supported by a 24-hour, seven day a week Single Point of Contact via telephone as well as a 24/7 health care assistant run Emergency Carer Support Service.
DHU is managing both services as part of a two-month pilot, with DHU’s 111 service referring the patients.
‘Fulfilling their wishes of staying at home’
Jill Davies (pictured above, left) is the Palliative Care Clinical Lead at DHU, she said: ‘’The advice line will provide a 24-hour point of access, seven days a week across Derbyshire. It means that any 111 calls from a family or carer supporting a patient on end-of-life care will be transferred to an Advanced Nurse Practitioner (ANP) who will have relevant experience in the provision of end-of-life care.
“The ANP will then triage and deal with the call appropriately, providing the necessary care where needed. This could be generating an electronic prescription to relieve pain or sickness or giving symptom management advice that will make the patient more comfortable. In circumstances where the problem cannot be resolved, the call will be transferred to another appropriate service in a timely manner so that the patient gets the right care they need to give them the best chance possible of fulfilling their wishes of staying at home.
“The Emergency Carer Support Service (ECSS) will help us to provide three ‘on call’ HCAs who will be available 24/7 across Derbyshire to provide crisis care and support, again to help keep people in their own homes. Staff will provide short term, ad hoc support until a more co-ordinated care plan can be put in place. This means assisting with personal care and incontinence care, as well as psychological and emotional support for patients, their carers and families. The HCA may see several patients in one shift but the support they will be able to provide will be invaluable to both the patient and the Palliative Care Team.
‘Complement rather than replace services’
“The service is vital for end-of-life patients who have tipped into crisis but wish to remain at home. For example, if their symptoms worsen, their condition deteriorates, they are waiting for a care package where existing services cannot provide support or it is out of working hours. It will complement rather than replace services such as the Hospice at Home teams or the Roaming Service and give these patients the best chance of having their wishes respected.
“Unfortunately, there are many people who find themselves in this position and at this stage of their care, where nothing is in place, patients may die before longer-term support can be provided. This can lead to unnecessary hospital admissions and an increase in deaths in hospital due to a lack of practical support for patients and carers at home. Together, these services give essential support to those patients who have expressed a wish to remain at home, die peacefully on their terms with dignity, in a comfortable environment and surrounded by loved ones.’’
The two month pilot schemes started in mid-June and will be reviewed later in the Summer.