The Health and Social Care Academy Integration Series Palliative Care: from acute to the community #palliativecarescot

Welcome Lisa Curtice People Powered Health and Wellbeing (PPHW) Programme Director #palliativecarescot

Panel Discussion Policy and strategy relating to palliative care and how this fits with integration – Mark Hazelwood, Chief Executive, Scottish Partnership for Palliative Care Service development in an integrated setting – Diana Hekerem, Marie Curie Divisional Business and Service Development Manager, Scotland How good palliative care can make a difference – Bill Whiland, Marie Curie Expert Voices Group Service on the ground – Caroline Paterson, Marie Curie Regional Manager Scotland (North) #palliativecarescot

Photo Photo - Highland Hospice

“Non-commercial provision of health care” – palliative care under Integrated Joint Boards. Diana Hekerem January 2016

Strategic Plans – Palliative Care 8 “Who wants to live forever?”

Strategic Plans supporting commissioning of Palliative and End of Life Care Marie Curie formally recognised as a Non- Commercial Provider of Health Care. Strategic Plans in general do not include: Data to support commissioning e.g. mortality rates, numbers with palliative care needs, admissions resulting in death Actions and services to address needs when “living well” is no longer possible Reference to hospice services and pathways Need to fast-track support for carers supporting patients with palliative and end of life care needs Recognition of dependency on voluntary sector for palliative and end of life care support BUT In Scotland, it is estimated that around 40,000 of the 54,700 people who die each year need some palliative care With the number of people dying in Scotland due to increase by 13% over the next 25 years, this problem will get worse unless we act now. 9 ONS (2014) based National Population Projections

Who are we talking to? 10 Strangers in the Night…

“non-commercial providers” Challenges Boards to HSCPs 14 to 31 Health to social care Increased number of organisations involved in pathways Benefits Strong user voice Volunteers Community engagement and support Subject matter expertise Notes: further details here (or delete) Source: details here (or delete) 11

Evidence Base? 12

Nuffield and OPM studies Source: OPM Evaluation Marie Curie Nursing Service. Dec 15 Source: Nuffield Trust: The impact of the Marie Curie Nursing Service on place of death and hospital use at the end of life

Measuring Outcomes 14

Integrated Care Fund - Evaluations 1: ? - Carers support 2: Patients supported by community palliative care 3: User feedback. Health Improvement Scotland and Care Inspectorate inspections 4: User involvement 5: LSE report on equity in palliative care 6: Carers support 7: Incidences & Inspections. 8: Training, clinical governance 9: Cost effectiveness of services; evidence impact of saving; use of fundraised income 15

16 For more information contact: Diana Hekerem Divisional Business and Service Development Manager Marie Curie Follow us on

#palliativecarescot How good palliative care can make a difference – Bill Whiland, Marie Curie Expert Voices Group

Marie Curie Nursing Service: delivering under integration. Caroline Paterson, Regional Manager Scotland (North) SEN,RN,Dip Ed, BA Specialist Practitioner District Nursing, Advanced Nurse Prescriber January 2016

Agenda 1.Overview 2.Services Funded through Integrated Change Fund 3.The future – closer partnership working 4.Main Challenges 20

Marie Curie in Scotland Source: 21

Services funded under Integration Source: ICF Monitoring Returns 22 Perth and Kinross Fast-track Service Provision of Marie Curie health and personal care assistants Working within DN and social care rapid response provision Collaborative working with social care teams “The fast track service has allowed our patients to be discharged from hospital in time to die at home allowing the patient there preferred place for end of life care.” DN Falkirk Out of Hours Service RNs based within Out of Hours team in Forth Valley Royal Referrals through palliative care line 130 visits per month 95% of patients supported by the service died in their preferred place of care. 96% satisfaction rating from carers. Glasgow Fast-track Discharge Service Discharge Liaison Nurses and senior health and personal care assistants Care to over 100 patients KPIs include monitoring potential bed day savings 80% discharge / 20 % admission prevention

Working more collaboratively 23 Helper Referrals from care homes, social care teams, DNs, hospitals, hospices patients, and carers. Awareness and collaboration with carers centres, community planning and other health charities Hospices Marie Curie – partnership with carers organisations, other hospices and health charities, schools & community groups Other hospices – part of referral and support for “hospice at home” type care. Training and Education Working with care homes and social care teams on one day and on-line learning. Engagement with range of palliative care educators

Working across systems Argyll and Bute Service Delivering Choice and Local Clinical Coordination Commissioned in 2012 to review needs 75% increase of people over 75 by 2037 Local clinical coordinated increased access for remote rural and non- malignant Other projects included care homes, transport, health promoting palliative care and informal carers The Lothian palliative care redesign programme aims to: · increase capabilities to identify patients and to plan care in anticipation, and in advance, of needs · improve coordination of care, within and across settings, to support patients and families with complex and unstable palliative and end-of-life care needs · increase community-based care service provision, and accelerate progress in shifting the balance of end-of-life care towards greater community-based care · increase public awareness of, and community involvement in, the issues related to death, dying and bereavement Notes: further details here (or delete) Source: details here (or delete) 24

25 Caroline Paterson Regional Manager Scotland (North) Marie Curie E mail Mon –

Panel Discussion Policy and strategy relating to palliative care and how this fits with integration – Mark Hazelwood, Chief Executive, Scottish Partnership for Palliative Care Service development in an integrated setting – Diana Hekerem, Marie Curie Divisional Business and Service Development Manager, Scotland How good palliative care can make a difference – Bill Whiland, Marie Curie Expert Voices Group Service on the ground – Caroline Paterson, Marie Curie Regional Manager Scotland (North) #palliativecarescot

Thank You! #palliativecarescot