transforming end of life care in surrey
Post on 31-Dec-2015
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Transforming End of Life care in Surrey
Our team today
• David Perry Chairman
• Nigel Harding Chief Executive
• Dr Fiona Bailey Medical Director and Consultant in Palliative Medicine
• Pam Walmsley Deputy Director of Clinical Services
Agenda
• Setting the scene
• Our care services
• The challenges we face
• Planning for the future
• Conclusion
Setting the scene• Our services are working at full capacity, serving over 5,500 patients and their families every year • Our current structure and facilities will not allow us to meet the increase in demand we expect from an ageing population with complex end of life needs
• The NHS challenge is keeping people out of hospital and beyond 2015 we have no certainty that we will have the ability to retain our site in Weybridge
• We have conducted a strategic review which has led to plans we believe will transform Hospice provision
Total numbers of patients
Comparing usage to giving:
Setting the scene
• The review produced a challenging Strategic Plan for the Hospices. With two key recommendations: • to reshape the organisation, moving to a single in-
patient unit• to grow capacity in day care and community care
services
• The loan from Woking Borough Council has enabled the Hospices to act quickly on these recommendations
• One in-patient facility with two community hubs
Our care services
Our care services• Hospice support in the home• Community Clinical Nurse Specialists• In-patient care• Day care units – over 2,600 attendances• Counselling for adults, young people and families• Complementary therapists• Occupational therapy• Physiotherapy• Spiritual care
The challenges we face
Growing need for Hospice care • 39% increase in the number of patients admitted since 2011
• 20% increase in patients referred to our Community Teams since 2011
• 7% increase in attendances to Day Care
• 20% increase in non-cancer referrals in the last two years
Pressure on care services expected to increase
• Annual mortality rate is set to rise by 2016
• People are living longer and more likely to have chronic disease
• The number of people living with Cancer will increase
• By 2021 over 1 million people will be living with dementia
• Projected 135% increase in population aged >85 by 2033
The need for our services has grown extensively and now we
must plan for the future
Options
• Do nothing – would result in longer waiting lists and an increase in hospital admissions
• Develop Woking Hospice site – cost approximately £4.5m – access to land denied, option not feasible
• Search for a green-field site and build a new hospice approximate cost £12m – timescale 6 -10 years
• Re-design an existing building – costs approximately £6.3m – timescale 3 years
Strategic choice
• Preferred option is to re-design an existing building to house a new hospice facility including a 20 bed in-patient unit• Appropriate building identified in Goldsworth Park,
Woking• Loan of up to £6m to acquire and re-design building
granted by Woking Borough Council to be repaid over 50 years• Loan unlocks Hospice plans and allows speedy
implementation of Hospice strategy in all key care services areas
• In-patient beds
• Community services
• Day care services
• Enhanced service efficiencies
Transforming end of life care
In-patient beds
• We need to keep 20 beds open• 20 beds on one site will improve delivery of service:• Ensure consistency• Enable prioritising patients with greatest need• Serve patients with complex needs better• Improve delivery of patient care• Ensure high quality care• Cost savings – reinvesting in services
Community services
• We will be able to support an increasing number of people in their communities and in their homes
• Continue to develop a responsive service that meet the needs of the community to enable them to stay at home
• Improved facilities from which the teams delivering this service can be housed
• Improved capacity to deliver education
Community HUB
Psychological Therapies Counselling Music/Art
Oncological Outreach Therapies
Additional Services: Hairdresser Bathing Chiropody Beauty treatments
Drop In Centre Resource / Information Welfare Advice Computer access Clinical Nurse Specialist avaialbe Duty Clinical Nurse Specialist available
Cafe Light refreshments Volunteer run
Base for: Doctors CNSs OT Physio Counsellors Admin
Outpatient Consultants clinics Nurse led clinics Therapist clinics
Carers Group
Therapeutic Models Educational programmes Complementary therapies Art / music therapies
Respite 5 days a week Focus to keep patients at home
Focus work for non-cancer patient care bundles
Medical Interventions: - blood transfusions - intravenous therapy
Education delivery to HCPs
Enhanced service efficiency
• Repatriate our Counselling services
• Space for equipment storage
• Inadequate parking facilities for our visitors which has caused distress to patients and their families at times
• Administration and Fundraising departments back under one roof with the rest of the services
Conclusion
• We will implement our plans and will provide regular progress updates• We will continue to work to improve our services• The re-location of beds from both Hospices will not
happen until 2016• Through our care provision we are aware of the close
bonds between people and communities to both in-patient facilities• We will work hard to ensure the transition is managed as
sensitively as possible
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