QIPP End of Life Care Event Report: Great Practice showcase

Source: National End of Life Care Programme

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Date of publication: April 2012

Publication type: Report

In a nutshell:  Showcasing best practice, this event brought together End of Life Care commissioners, End of Life Care education leads, service managers and clinical practitioners to share learning about the tools available to deliver the QIPP challenge in this sector.  Key learning is summarised and there is an overview of the presentations and links to case studies and marketplace exhibitors.

Length of publication: 15 pages

Understanding the cost of end of life care in different settings

Source: Marie Curie  

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Date of publication: February 2012

Publication type: Report

In a nutshell: This report from Marie Curie’s considers the economic impact of providing care to patients in the community, rather than in the acute setting and presents a clear argument for the development of high-quality community-based care.  Marie Curie estimate:

• community care at the end of life costs £145 per day
• specialist palliative in-patient care costs £425 per day
• changing the setting of care could reduce daily costs by £280.
• between 355,000 and 457,000 patients need palliative care annually.
• If community services were developed to enable just 30,000 patients to reduce their hospital stay by just four days, there could be a saving of £34 million.

Length of publication: 8 pages

Older people living alone at the end of life in the UK: research and policy challenges

Source: Palliative Medicine,  2011, vol./is. 25/6(650-657), 0269-2163 (2011)

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Date of publication: September 2011

Publication type: Article

In a nutshell: In light of recent emphasis on place of death in UK policy, this article reviews some of the challenges faced by older people who live alone towards the end of life.  The implications of issues that impact on opportunity to achieve their preferred place of death are addressed including, finances, support mechanisms and the home environment.

Length of publication: 8 pages

Some important notes: This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library 

Acknowledgement: BNI 

Deaths from liver disease: Implications for end of life care in England

Source: National end of life care Intelligence Network

Follow this link to download the full report

Date of publication: March 2012

Publication type: Report

In a nutshell: This report presents the latest data on place of death for those with liver disease and shows how this varies with sex, age, region, socioeconomic deprivation and place. It is aimed at commissioners and providers of end of life care, clinicians caring for patients with liver disease, and others concerned with providing quality end of life care for this patient group, including patients themselves and their carers.

Length of publication: 36 pages

Anticipatory care planning and integration: A primary care pilot study aimed at reducing unplanned hospitalization

Source: British Journal of General Practice, 2012, 62, (595) (e113-e120)

Date of publication: February 2012

Publication type: Article

In a nutshell: This article reviews a pilot study in Scotland which aimed to provide anticipatory care plans (ACPs) for patients who were at risk of hospital admission. Patients’ wishes in the event of sudden deterioration in their health were recorded.  The pilot achieved statistically significant reductions in unplanned hospitalisation for patients with multiple morbidities and  demonstrates the potential for providing both better care as well as better value for health and social care services.

Length of publication: 8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement: Embase

Critical success factors that enable individuals to die in their preferred place of death

Source: National End of Life Care Programme

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Date of publication: February 2012

Publication type: Report

In a nutshell: Based on contributions from end of life care commissioners and providers of services within seven Primary Care Trusts, the report is intended as a starting point to help those commissioning and planning services to see what has worked well in other areas.

The factors that are considered critical are (not ranked):

• Strong commissioning and clinical leadership
• Use of nationally recognised drivers that attract payment – LES and CQUINs
• Flexible budgets and care packages
• Use of nationally recognised tools or their local equivalent – ACP, GSF, LCP, PPC, ADAs and CHC Fast Track Pathway
• Shared electronic information systems
• Clearly defined access to 24 hour cover
• Development of care homes
• Use of facilitator roles and co-ordination of care across boundaries
• Training to support staff delivering end of life care.

Length of publication: 88p.

Acknowledgement: National End of Life Care Programme

Deprivation and death:Variation in place and cause of death

Source:  National End of Life Care Intelligence Network (NEoLCIN)

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Date of publication: February 2012

Publication type: report

In a nutshell:  The purpose of this report is to  improve  understanding of socioeconomic deprivation as a factor influencing end of life care. Highlighting known and unknown  variations, such as:  differences in age and cause of death by deprivation;  differences in place of death by deprivation.  The report contributes to the evidence base and should prove useful for commissioners and providers of end of life care in terms of planning services and tackling inequalities.

Length of publication: 44 pages

Acknowledgement: National End of Life Care Programme

Evaluating Program Integration and the Rise in Collaboration: Case study of a palliative care network

Source: Journal of Palliative Care, Winter 2011, 27, (4), p.270 -279

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Date of publication: Winter 2011

Publication type: Article

In a nutshell: This article focuses on an attempt to build capacity to deliver palliative care in an integrated way across a range of communities in Ontario, Canada.  The objective was to achieve an effective integrated system that was cost-effective and responsive to patient’s needs.  14 communities were involved and overall the approach appears to be beneficial.  Change has been gradual and structural issues continue to be a challenge.

Length of publication: 9 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library. 

Involving older people in commissioning: more power to their elbow?

Source: Joseph Rowntree Foundation

Follow this link for the full report

Date of publication: December 2011

Publication type: Report

In a nutshell: This research set out to investigate what happens when older people are given the opportunity to shape service commissioning and delivery. The study also raises wider questions about the impact of their involvement, particularly whether it can change the nature of local power relations in the long term.

Length of publication: 76 pages

Acknowledgements: National End of Life Care Programme

National End of Life Care Programme Newsletter November 2011 – Theme: Social Care

Source: National End of Life Care Programme

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Date of publication: November 2011

Publication type: Newsletter

In a nutshell: This edition of the newsletter includes features:   

• Pressing ahead with the social care agenda which is about the progress made in the ’Supporting people to live and die well’ programme
• Meeting the end of life needs of people with MND
• Testing out e-Elca in a large acute Trust

Length of publication: 14 pages

Issues facing commissioners of end-of-life care

Source: The King’s Fund

Follow this link for summary and to download free fulltext.

Date of publication: September 2011

Publication type: Report

In a nutshell:  End-of-life care services are typically funded and delivered by a range of organisations including the NHS,  local government, the voluntary sector and independent agencies, charities and through informal or formal donations. This growing complexity coupled with demands on end-of-life care services means that commissioning services is challenging.  This document addresses the current complex arrangements around EoLC funding and highlights barriers as well as the opportunities commissioning offers.

Some of the issues that make end-of-life care important for commissioners include:

• demographic changes =  an increase in the number of deaths and also increases in the number of people living with complex and co-existing  diseases
• government’s end-of-life care strategy clearly emphasises that eolc is a local commissioning priority
• several monitoring and incentive programmes are aimed at improving the quality of care.

Length of publication: 24 pages

Acknowledgement: The King’s Fund

QIPP End of Life Showcase Events for Clinical Commissioners

Source:  National End of Life Care Programme

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Date of publication: November 2011

Publication type: News

In a nutshell:  This series of four identical showcase seminars staged throughout the UK are funded by the QIPP End of Life national workstream in order to equip commissioners improve quality and drive down costs. They are designed around sharing best practice in community interventions at end of life and feature presentations from five organisations already achieving high quality, value for money outcomes for their end of life patients.

The purpose of these showcase events are:

• To give commissioners an overview of the current challenge and opportunity for QIPP at the end of life.
• To demonstrate models of community support at end of life that deliver desired quality, innovation, productivity and prevention outcomes
• To stimulate debate about critical success factors for effective commissioning at end of life
• To provide material which will support clinical commissioners and others in delivering QIPP at the end of life.

National end of life care strategy: third annual report

Source:  National End of Life Care Programme

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Date of publication: September 2011

Publication type: Report

In a nutshell: Produced by the Department of Health, this comprehensive report on the National EoLC Strategy details progress over the last year in the context of significant political, organisational and financial changes.  New key drivers are identified and mechanisms to incorporate them into the programme are set out.  Chapters include: Meeting the challenges of EoLC; The information revolution for people approaching the end of life; Improving outcomes for people approaching the end of life (care planning, coordination and delivery and commissioning).  The next steps for the programme are described in detail. 

Length of publication: 82 pages

National End of Life Care Programme Newsletter October 2011 – Theme: Acute Care

Source: National End of Life Care Programme

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Date of publication: October 2011

Publication type: Newsletter

In a nutshell: This edition of the monthly newsletter contains articles on:

• Events for Commissioners
• Palliative and end of life rapid discharge pathway
• Spreading end of life care best practice in Acute Trusts
• Improving kidney patients end of life care  

Length of publication: 10 pages