One Chance to Get it Right Improving your palliative care knowledge and skills

One Chance to Get it Right 1.30pm: Overview from Mike Stockton 1:45pm : Group Work / Case studies Pain Advanced Care Planning Anticipatory Prescribing Closing remarks: Gill Pottinger

Outcomes for the session To recognise when a patient is in the palliative care phase & the services/systems that are available to support them To ensure that patients symptoms are assessed and managed in a consistent way with the right intervention To feel confident making these decisions and having these conversations & knowing how to follow up with other health care professionals To make appropriate & timely referrals to palliative services to enable maximum support and symptom management.

Palliative and End of Life Care for Leeds Overview By Mike Stockton

Ambitions for End of Life Care National Framework 2015-2020 Each person seen as an individual Each person gets fair access to care Maximising comfort and wellbeing Care coordinated All staff prepared to care Each community prepared to help

Identification…who may benefit Health is deteriorating despite maximal therapy Maximal therapy is not appropriate or desired Focus of care prioritises comfort, wellbeing and symptom management This may include patients whose prognosis is difficult to determine and could be more than a year. Consider all conditions including LTCs, dementia, frailty

Death in Leeds 6800 deaths per year 75% of deaths estimated to benefit from palliative care approach 5000 deaths per year across Leeds would benefit from palliative care

Death and Dying in Leeds Cause Dementia mentioned in 15% Rising Multimorbidity Age Age % 0-64 17 65-74 15.5 75-84 30.2 85+ 37.3 Disease % Cancer 27% Circulatory Respiratory 13%

Death and Dying in Leeds Where People Die… (2015) Last 10 year trend Hospital Home Care Home Hospice 45.3% 23.4% 20.6% 8.4% Hospital Home Care Home Hospice 11% reduction 4% increase 6% increase 1% increase

Death and Dying Future Trends By 2040… Annual deaths projected to rise 25% Greatest rise in the 85+ group Palliative care need may rise as high as 40% In Leeds, up to 1,700 additional patients per year requiring palliative care Main drivers of need are predicted to be: Cancer Dementia Frailty LTC

Leeds Palliative Care Provision Palliative & End of Life Care Specialist Generalist Hospice In Patient Hospice Community Hospital Community Hospital Neighbour End of Life Teams Primary Health Care Team Care Homes Adult Social Care Hospital EOL teams Site specific CNS Ward Teams St Gemma’s 32 beds Wheatfields 18 beds SPC CNS Medical Services Day Services SPC Team

MCN…what is it? Delivering improved outcomes Collaborative partnership of all palliative and end of life providers Whole system issues and approach Delivering improved outcomes Service improvement Medicines management Education and research Information and technology

The Partners Core Group Peripheral Partners

Information Management Leeds MCN Leeds MCN Highlights so far… Service improvement Transfer of care Heart failure project Dementia and end of life group Integration with Leeds frailty work Medicines Management New guidelines for opioid prescribing Anticipatory drugs at the EOL Information Management Leeds Care Record EPaCCS & coordination Metrics suite New bereaved carers survey Education Tele-education (ECHO) TARGET EOL learning outcomes Refreshed communication skills training

THANK YOU…. Now Group Work