PEACE in Coastal West Sussex- how was it for us?

Introduction The session will cover: Why we signed up to be part of the project Where we are, our demographic, the challenges and opportunities How we set the project up, the planning process What happened next? Perspectives of the team on the PEACE experience The views of patients and carers, care home staff Reflections on our experiences and lessons learnt Next steps and future plans…….

Introducing the project team Why did we join the PEACE project?

Where is Coastal West Sussex? Coastal WS CCG covers almost 65% of West Sussex We have 6 Localities There are 52 GP practises An annual budget of more than £580million 2 acute hospitals 3 specialist palliative care providers Over 300 care homes Total population now exceeds 500,000

The CWS Population

What did we do first. How did we decide on the model What did we do first? How did we decide on the model? What happened next?

CWS PEACE model principles. 1. Patient identified who would benefit from developing Peace plan in discussion with the care home/ following recent admission 2. 1st discussion takes place led by admission avoidance care homes matron 3. Provide patient/family, staff information 4. Admission avoidance care homes matron can draw on support from GP, Care of Elderly consultant, EOLC specialist on as required basis. 5. ALL plans signed by GP, Care of Elderly consultant, EOLC specialist 5. Share plan via proactive care MDT coordinators/ GP. Identify key worker and plan uploaded to IBIS / one call. 6. Review plan as appropriate to individual circumstance. Care home   New Grange ( Care home) Aldersmead ( Nursing home) Admission avoidance care home matron Ria Evans Sonja Rosell/ Fiona Stevens ( from Feb 2015) Supported by GP champion Bikram Raychaudhuri (until Feb 2015) Beth Meek Consultant Care of the Elderly support Tom Saunders Jackie Pace End of Life specialist support Suzanne Ford- Dunne Brendan Amesbury

The admission avoidance care homes matron perspective Film in here What were our first thoughts about piloting PEACE? Introducing the idea to care homes, training and getting ready Experience of completing the plans

The GP’s perspective What benefits were foreseen? Film in here What benefits were foreseen? What were the initial challenges ?

The consultant’s perspective Film in here What did I fear before we started? What happened in practice ?

The care homes perspective Film in here What did we think when PEACE was first talked about? What happened in our care home?

Patient and carer views Film in here How was PEACE first introduced ? Views on the PEACE experience

Reflective views……… Film in here Our experiences Mental Capacity issues

Reflective views…….. Film in here What lessons did we learn? Ideas for the future…..

Next steps and future plans…..

Any questions for the panel?

Thank you