CASE STUDY
We know about
end of life
care
Grampian
Partnership working to deliver urgent out-of-hours care Marie Curie Cancer Care delivers a responsive, high-quality out-of-hours nursing service for end of life patients, in partnership with Moray Community Health & Social Care Partnership and Aberdeenshire Community Health Partnership. The issue • NHS Grampian was providing outof-hours nursing services through a variety of service models across Aberdeenshire and Moray. More than 95% of calls to these services were for end of life patients. • The NHS established the need for a more consistent and equitable approach to palliative care across the region, to improve both efficiency and quality of care. The • new model needed to deliver on the Grampian Palliative Care Strategy to increase the proportion of care provided to palliative patients in their preferred place of care.
The service solution Marie Curie’s rapid response service operates from 8pm to 8am, from three hubs in Elgin, Peterhead and Stonehaven (we are developing an additional hub in Aberdeen). Each hub includes a Registered Nurse and senior healthcare assistant. The Marie Curie Nurses work closely with the out-of-hours doctor, nurse practitioners, and the daytime district nurse team to make sure patients can access high-quality nursing care at home when they need it. Patients must be aged 16 or over and registered with a general practitioner in Aberdeenshire or Moray. Patients can access support by calling NHS 24; they are then passed onto the Grampian out-of-hours GP service, which coordinates the Marie Curie service. District nurses can also refer patients if they think they may need care outside normal working hours. Marie Curie Nurses also work with day community nursing teams to improve other clinical interventions, such as catheter care, within district nurse operating hours, to minimise the need for out-of-hours support.
CASE STUDY
84% of recorded patient deaths were at home.
Grampian
Service benefits • The service saw 1,376 patients from May 2011 to April 2012 and delivered 2,702 visits – an average of nine visits per night across the two community health partnerships. • Patients able to die in their place of choice – 84% of recorded deaths were at home, with only 7% in hospital. • Extremely high levels of user satisfaction. Ninety-six per cent of patients and carers felt the service met their needs all or most of the time. The majority of district nurses were satisfied with the service overall (82%) and felt that the service met the needs of their patients (88%). • Equity of access for non-cancer patients to Marie Curie Nursing Service – 66% of service users had conditions other than cancer, including dementia, multiple sclerosis and heart or renal failure. • Equity of provision across two community health partnerships.
“The challenge was to deliver sustainable, quality out-of-hours nursing across a remote and rural geography. The Marie Curie Aberdeenshire Community Health Partnership (CHP) and Moray CHP G-Med coordinated out of hours palliative nursing service is an excellent example of integrated working helping deliver 24/7 high-quality palliative care in patient’s homes.” Eunice Chisholm, Head of Nursing, NHS Grampian
96% of patients and carers felt the service met their needs all or most of the time.
Charity reg no. 207994 (England & Wales), SC038731 (Scotland) S276g_Casestudy_Grampian
Contact servicedevelopment@mariecurie.org.uk mariecurie.org.uk/commissioning