1. Palliative Care Services in Bradford and Airedale

2. Palliative Care Co-ordination service Planning Planning Clinical Governance Clinical Governance Education Educationwww.palliativecare.bradford.nhs.uk

3. Hospices Marie Curie BradfordManorlands 16 Inpatient beds 16 10 /day Day therapy unit 15/day Community palliative care teams

4. Hospital teams CNS and consultants Advisory service Shared Care

5. Hospice at home Nursing team with extended skills in palliative care Nursing team with extended skills in palliative care Community based Community based Focused on later stage of illness, facilitating keeping patients at home. Focused on later stage of illness, facilitating keeping patients at home.

6. Eligibility Criteria The patient has active, progressive and usually advanced disease for whom the prognosis is limited (although it can be several years) and the focus of care is quality of life.

7. Eligibility criteria The patient has one or more of the following needs which are unmet: The patient has one or more of the following needs which are unmet: Uncontrolled or complicated symptoms.Uncontrolled or complicated symptoms. Specialised nursing/therapy requirements.Specialised nursing/therapy requirements. Complex psychological/emotional issues.Complex psychological/emotional issues. Complex social or family issues.Complex social or family issues. Difficult decision making about future care.Difficult decision making about future care.

8. Hospice inpatient care Terminal care: for people who are expected to die within two weeks. Symptom control/Assessment / Reassessment: where the patient’s physical, social, psychological or spiritual problems have proved difficult to manage in the community or hospital setting. Rehabilitation: e.g. following spinal cord compression or debilitating treatment.

9. Hospice admissions -Respite Regular respite care can not be offered. Regular respite care can not be offered. Respite care in a hospice is more likely to be appropriate when the prognosis is short i.e. less than six months. Those with longer prognoses are often more appropriately offered respite care in a nursing home setting. Respite care in a hospice is more likely to be appropriate when the prognosis is short i.e. less than six months. Those with longer prognoses are often more appropriately offered respite care in a nursing home setting. The hospices are not able to provide booked holiday respite The hospices are not able to provide booked holiday respite

10. Hospice inpatient care -Respite Patients with ongoing difficult physical, psychological or social problems, even though these may be stable. Patients with ongoing difficult physical, psychological or social problems, even though these may be stable. Short prognosis (i.e. weeks or a few months) Short prognosis (i.e. weeks or a few months) complex or intensive nursing needs complex or intensive nursing needs (eg. Some of those with MND) (eg. Some of those with MND) Crisis respite Crisis respite (e.g. carer fatigue/illness or breakdown of care package ) (e.g. carer fatigue/illness or breakdown of care package )

11. Referrals Airedale hospital - 291 Bradford hospitals - 407 Manorlands - 425 Marie Curie - 532 Bradford Community - 619 Hospice at home - 124 Total - 2398

12. Age of patients seen Under 25 - 5 (<1%) Under 25 - 5 (<1%) 25-64 - 389 (27%) 25-64 - 389 (27%) 65-74 - 389 (27%) 65-74 - 389 (27%) Over 75 - 683 (47%) Over 75 - 683 (47%) Total - 1466 Total - 1466

13. Length of stay CommunityHospital Day therapy Hospice at home < 2 weeks 17%87%4%31% 2-4 weeks 10%10%9%19% 4-6 weeks 9% 9%2%8%16% 6-12 weeks 18%1%16%18% 3-6 months 17%-26%6% > 6 months 29%-37%12%

14. Hospice inpatients < 2 weeks 339 (59%) 2-4 weeks 149 (26%) 4-6 weeks 56 (10%) 6-12 weeks 32 (6%) 3-6 months 3 (1%) >6 months - Total579

15. Who can refer Professionals Professionals Family Family Patients Patients

16. How to refer Common referral form Common referral form Hospice at home teams Hospice at home teams Airedale – 01535 294656 Airedale – 01535 294656 Bradford - 01274 323575 Bradford - 01274 323575

17. What do we do Holistic approach to care through MDT Expertise in : symptoms, social and psychological problems that patients and families face when they are given a limited prognosis. symptoms, social and psychological problems that patients and families face when they are given a limited prognosis. End of life care End of life care Experience in the ethical dilemmas that can arise in this area of care. Education and support for professionals