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Hospice UK National Conference 2017: working across boundaries

Author: Leila Hawkins
07 December 2017
  • Kay Greene
  • Dr Lucy Martin

Max Watson, Project ECHO Programme Director at Hospice UK, chaired an insightful talk at Hospice UK's National Conference about working across boundaries to deliver hospice care at home.

Kay Greene, Chair of the National Association for Hospice at Home (NAHH) and Director of Clinical Services at Mary Ann Evans Hospice in Nuneaton, Warwickshire, began by explaining the significance of hospice care at home. “It is essentially a hospice without walls” she said. The NAHH currently provides care for around 240 patients at home, and their mantra is "to support people to die in their preferred place."

The organisation has seen a 77 per cent increase in membership in the last four years, and their vision includes maintaining a person-centred approach, providing training to give injections, reducing care anxiety, increasing community engagement, and improving the skills of  nurses, practitioners and assistants.

Greene described north Warwickshire as a "deprived” area, with many hard to reach groups. Initiatives like Project ECHO will be beneficial, she said.

Project ECHO is a lifelong learning and guided practice model that revolutionises medical education and clinical team support. ECHO, which stands for Extension of Community Healthcare Outcomes, was originally developed at the University of New Mexico. At the heart of the ECHO model are its hub-and-spoke knowledge-sharing networks. These networks of generalists and specialists are supported to form communities of practice with the input from the hub of dedicated IT, administration and trained facilitation of the virtual meetings. 

"We don't want to overcomplicate or over-medicalise care" Greene said. "Hospice at home needs a local needs-driven model."

Dr Lucy Martin, Medical Director at Mary Stevens Hospice in Dudley, and Chair of the national pilot of Macmillan Specialist Care at Home, has been heavily involved in a model to integrate community palliative and primary services with the aim of increasing access to palliative care for non-cancer patients and reducing deaths in hospitals.

She explained that this model is particularly important to the local area because Dudley’s industrial heritage has meant there is a legacy of illnesses among the population, along with great inequality.

The project involved working with the primary and secondary care sectors along with hospice clinicians to tackle national priorities such as increasing access to hospice care at home.

With the support of their trustees and a grant, they hired consultants, a project manager, admin staff and a volunteer coordinator. This meant they were able to better manage their volunteer service, providing someone to visit the patient in their home at the right time, and who could talk to them about non-medical issues.

The initiative also reduced deaths in hospitals from 53.7 to 44.8 per cent in two years.

Dr Martin explained that the project taught them about the power of data collection, the importance of building in the communication of a story to gain support from trustees and grant givers, and that strong clinical leadership is key.

Their next steps are to develop a Dudley-wide end of life care strategy, integrate further with the local authority, and build on a multispeciality community provider to move care closer to people's homes.

For more information visit Hospice UK National Conference 2017

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