Hospice and Local EOLC update 2016 Dida Cornish

Hospice Community Support Malignant or non-malignant Don’t have to refer every-one 4 Hospice Community CNS Teams-Working with the primary health Care Team - Psychological support - Symptom Control advice - Co-ordinate admission to hospice - Visit weekly, monthly or telephone contact - One off visits for advice about services - Open appointment if not needing active involvement

Other Hospice Services 24 hour Advice Line for professionals in the community 0117 915943 - Calls taken by access team nurses 7/7 a week day time - IPU nurses evening - senior Doctor always available Hospice Medical Team - OPA or DV’s for most complex Inpatient for symptom control/end of life (1-2 week) - Can do paracentesis, treat hypercalcaemia, blood Tx Day Hospice - Symptom control/therapies/rehab – 12 week programme - Fatigue and Breathlessness – don’t have to be known to us (FAB) Hospice at Home - Last days of life: shifts up to 24hr care and respite shifts

Other Hospice Services For patients/carers/families known to hospice access to: - Physio/OT - Psychological support and spiritual care (multi faith) - Complementary therapy - Care support 1 to 1 and drop in - Bereavement support - Hospice Neighbours-volunteer befriending/odd jobs

Hospital / CCG Initiatives Identify patients in their last 6-12 months is everyone’s business (Bristol CQUIN 2015) Acute trusts will be identifying and communicating with GP’s about these patients on discharge UHBristol: Poor prognosis letters, should identify if conversations have started in hospital NBT: Tick box on discharge letter ‘suitable for GSF meeting’ Both trusts using locally adapted Prognostic indicator Guidance.

CCG/Regional Initiatives Single Point of Access for end of life support e.g. Bristol Care Co-ordination - Access to H@H, Marie Currie and PCHS - 8am – 6pm 7 days a week 0117 9828315 Electronic Palliative Care Co-ordination System - To replace end of life register on adastra - Embedded in EMIS web/connecting care

NICE guidelines: last days of life Recognising when a person may be in last days of life Communication Shared decision making Individualised care plan Maintaining hydration - mouth care -? Trial of CAH for thirst Pharmacological interventions Anticipatory prescribing

Resources http://www.stpetershospice.org.uk/healthcare-professionals-gidelines/ Care of Dying adults in last days of life https://www.nice.org.uk/guidance/ng31/chapter/Recommendations http://learnzone.macmillan.org.uk/login/index.php http://www.e-lfh.org.uk/programmes/end-of-life-care/