Transforming End of Life Care in Acute Hospitals PM Workshop 6: Working together - Building on the best by Professor Bee Wee, NHS England, Adrienne Betteley, Macmillan Cancer Support, Anita Hayes, The National Council for Palliative Care
2. Macmillan’s current activities are focussed on four
core areas
Existing assets and people Advance Care Planning
Partnerships and Innovation Influencing
• Buildings including palliative day care (20),
palliative inpatient (59), Oncology (40) and
Information Centres (104)
• 551 palliative care beds
• Approx. 1,700 posts
• L&D offer including face to face courses, e‐
learning and grants
• To ensure people approaching the end of life
receive support to die in the place they
choose
Pushing for a commitment to
implement free social care at the end
of life (England)
Improving healthcare support/services
for people approaching the end of life,
e.g. 24/7 community nursing
3. What is NCPC?
• The umbrella charity for palliative and end of
life care
• Influences government policy
• Supports all sectors involved in providing,
commissioning and people using services
• Promotes equity of access to palliative care
and good end of life care for all
• Key priority-models to support more people
people with multiple conditions& dementia
• Dying Matters Coalition
4. The Dying Matters Coalition
Dying Matters was set up by the National Council for
Palliative Care, the umbrella charity for all those involved in
palliative care, to support the 2008 End of Life Care Strategy
Our aim is to raise public awareness about the importance of
talking more openly about dying, death and bereavement and
of making your wishes known
Dying Matters has over 32,000 members ranging from health
and care organisations, funeral directors, legal and financial
organisations and thousands of individual members
10. "Those with experience
of relatives dying in
hospitals report
the medical support is
not as good as expected,
while personal support is
poor, but as expected."
Sue Ryder, a time and a
place[12]
69% of bereaved people whose relative or friend died in a
hospital, rated care as outstanding, excellent or good. Significantly
lower than hospice (83%), care home (82%) or at home (79%). England,
VOICES‐SF survey
33% reported that the hospital services did not
work well together with GP and other services outside the
hospital. England VOICES‐SF survey [7]
some aspects of the dying
environment as being more
important than physical
location. [11] Choice
report
More than 73% respondents felt
hospital was the right place for their
friend or relative to die, despite only 3%
of all respondents stating patients
wanted to die in hospital. [7]
“Sometimes, it's
the little things
that matter, and
that is what you
remember.”
Expert with lived experience. [10]
While the majority said choice is important, many
said an important consideration was quality. [11]
Themes from ombudsman report [13]
•Not recognising people are dying, not responding to
need
•Poor symptom control
•Poor communication
•Poor care planning (hospitals and GPs liaise)
•Delays in diagnosis
Hospital staff received
the lowest
proportion always
showing dignity and
respect (58% for
hospital doctors and 51%
for hospital nurses). [7]
Most bereaved people did not
talk to anyone from any support
services since the death, most.
18% said they had not, but
would have liked to. VOICES‐SF
13. Aim:
2 stones
lighter!
Energy Out
Energy In
Walk daily
commute
Stairs not
lift
Exercise
Reduce
alcohol
intake
Eat Less
Pedometer
Gym work
out 3 days
Squash
weekends
No pub
weekdays
Take
packed
lunch
Low fat
meals
Driver Diagrams ‐ weight loss