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

2. 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

3. 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.

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

6. 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

7. 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

8. 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

9. 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%

10. 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

11. 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

12. 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

14. 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

15. The Partners
Core Group
Peripheral Partners

16. 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

17. THANK YOU….
Now Group Work