Empowering Better End‐of‐Life Dementia Care (EMBED‐Care): A mixed methods protocol to achieve integrated person‐centred care across settings

Source: International Journal of Geriatric Psychiatry 2020; 1-13

Follow this link for fulltext

Date of publication: January 2020

Publication type: Article

In a nutshell: This article looks at the Empowering Better End‐of‐Life Dementia Care (EMBED‐Care) programme, which has been developed to help those with dementia who need palliative care. The programme hopes to understand current and future need, develop novel cost‐effective care innovations, build research capacity, and promote international collaborations in research and practice to ensure people live and die well with dementia.

Length of publication: 13 pages

Cost-effective commissioning of end of life care: understanding the health economics of palliative and end of life care

Source: Public Health England

Follow this link for fulltext

Date of publication: February 2017

Publication type: Report

In a nutshell: The first half of this report presents the findings of a review of the available literature on the costs and effectiveness of different initiatives and schemes designed to improve patients and carers experiences at the end of life. The second half of this report describes the new end of life care economic tool and the methodology underpinning this tool.

Length of publication: 72 pages

Some important notes: A user guide and analytical tool are also available to support this report.

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Source:  The Cochrane Library

Follow this link to download the review

Date of publication: June 2013

Publication type: Systematic Review

In a nutshell: A new review from the Cochrane Pain, Palliative and Supportive Care Group looked at the impact of home palliative care services on the chances of dying at home and on other outcomes for patients and their caregivers, such as symptom control and quality of life. The review team also aimed to compare resource use and costs associated with these services and summarize the current evidence on cost-effectiveness.

Length of publication: 281 pages

Midhurst Macmillan Community Specialist Palliative Care Service: Delivering end-of-life care in the community

Source: The King’s Fund

Follow this link to download the full-text report

Date of publication: August 2013

Publication type: Report

In a nutshell: the aim of this report was to establish whether community specialist palliative care services offering home nursing increased rates of death at home (avoiding hospitalisation) compared to other models. The review concluded that the evidence that palliative care home nursing for patients with life-limiting illnesses increased the rate of death at home without compromising symptoms, quality of life or increasing costs was inconclusive. The authors’ conclusions are suitably cautious given the limited evidence available.

Length of publication: 34p.

 

Tried and tested End of Life Care Modelling Tools launched

Source: National End of Life Care Intelligence Network

Follow this link for website

Date of publication: May 2012

Publication type: Website

In a nutshell: Eight early adopter sites across England have worked with the National End of Life Care Programme to trial a set of modelling tools to support end of life care commissioners and planners.

The updated tools are now freely available on the National End of Life Care Intelligence Network website together with a range of supporting materials, including workbooks and case studies from the early adopters.

There are three modelling tools:

• The Cohort Model that identifies the end of life care needs of their population over a 10-year period
• The Skills for Health Functional Analysis tool, which assesses workforce skills required to ensure quality end of life care provision
• The Yorkshire & the Humber Co-Design Model, which assesses how many people dying in hospital could reasonably end life in an alternative care setting and provides costings for Alternative Care Pathways.

Acknowledgement: NHS National End of Life Care Programme

Allied Health Professionals (AHP) QIPP Toolkits

Source: NHS Networks

Follow this link for the website

Date of publication: April 2012

Publication type: Website

In a nutshell: The Strategic Health Authority AHP Leads for England have worked with NHS London who compiled the AHP QIPP Toolkits These are designed to help commissioners design services that are of high quality whilst reducing cost.

Acknowledgement: NHS National End of Life Care Programme

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

A narrative literature review of the evidence regarding the economic impact of avoidable hospitalizations amongst palliative care patients in the UK

Source: Progress in Palliative Care 2011 v.19(6), p291-8

Follow this link for article abstract

Date of publication: November 2011

Publication type: Article

In a nutshell: This article carries out a  narrative review of the evidence relating to the potential economic impact of reducing avoidable admissions among palliative care patients in the UK. The article concludes that the evidence base from the UK relating to the economic impact of avoidable admissions in palliative care is limited. Although two recent retrospective studies suggest that there are currently high levels of avoidable admissions, the feasibility of avoiding such admissions and the full economic consequences of such changes have not been clearly demonstrated. Further evidence is needed to provide a more robust estimate of the extent to which the additional costs of providing high-quality community support are offset by reduced inpatient usage by palliative care patients.

Length of publication: 8 pages

Some important notes: Contact your local health library for a copy of this article. Follow this link to find your local health library.

Comparing the costs of alternative models of end-of-life care

Title: Comparing the costs of alternative models of end-of-life care

Source: Journal of Palliative Care 2011 Summer; 27(2), p126-33

Follow this link for article abstract

Date of publication: Summer 2011

Publication type: Article

In a nutshell: This study explores the financial consequences of decreased acute care utilisation and expanded community-based care for patients at the end of life in England. Results suggest that reducing reliance on acute care could release resources and better meet peoples’ preferences.

Length of publication: 8 pages

Acknowledgements: Pubmed

Contact your local health library to obtain a copy of this article. Follow this link to find your local health library.

The King’s Fund paper on issues facing end of life care commissioners

Title: The King’s Fund paper on issues facing end of life care commissioners

Source: King’s Fund

Follow this link to download the full report

Date of publication: September 2011

Publication type: Report

In a nutshell: This report looks at the options for funding end-of-life care at a local level and also seeks to address what works in the commissioning and provision of end-of-life care, highlighting current barriers in funding and commissioning as well as the opportunities commissioning offers

Length of publication: 25 pages

Acknowledgements: NHS National End of Life Care Programme

Provision of palliative care services: putting policy into practice

Source: British Journal of Community Nursing 2011 vol. 16(8) p390

Follow this link for the abstract

Date of publication: August 2011

Publication type: Article

In a nutshell: This article discusses the outsourcing of primary care palliative care services to 3rd party providers to meet cost cutting targets. The author asks the question, “Does it matter who provides palliative care services as long as they meet the needs of the people they are there for?”. The author questions how the voluntary and private sector organisations will monitor and measure outcomes and how will they be called to account for the service they provide as poorly managed end-of-life care and bereavement can have a devastating impact on people and can lead to further problems.

Length of publication: 1 page

Some important notes: Please contact your local health library for a copy of this article. Follow this link to find your local health library.

New tools for London end of life care services commissioners

Source: London Health Programmes

Follow this link to access the tools on the London Health Programmes website

Date: July 2011

Publication type: Website

In a nutshell: NHS Commissioning Support for London (now London Health Programmes) has launched a range of tools to support commissioners in planning end of life services, including

•  a good practice guide
• economic modelling tool
• London QIPP priorities

Acknowledgements: NHS National End of Life Care Programme

Maximizing palliative care provision in economic downturns

Source: International Journal of Palliative Nursing 2011 17(1): 4-6

Follow this link for the fulltext article

Date of publication: 2011 Jan

Publication type: Article

In a nutshell: In these difficult economic times, the argument for good-quality end-of-life care has moved away from ethical to economic considerations. This commentary puts forward Ireland’s case for reallocating some of current health spending away from acute services towards community-based palliative care services.

Length of publication:2 pages

Some important notes: An Athens password is required to access this article online. To register for Athens, follow this link.

The costs and savings of a regional public palliative care program: the Catalan experience at 18 years

Source: Journal of Pain Sympton Management 2009 Jul;38(1):87-96

Publication Type: Journal article

In a nutshell: The palliative care program in Catalonia illustrates the impact that similar initiatives may have in terms of cost savings for a regional health system. In a publicly funded and freely accessible health service, decreasing the number of hospital admissions, shortening the lengths of hospital stay, reducing the frequency of emergency department consultations, shifting the use of acute beds to palliative care beds for treating advanced disease inpatients, and substantially improving the use of opioids in the community are major determinants of the palliative care program’s success, which in turn will improve the quality of health care at the end of life.

Document Length: 9 Pages

Notes: Contact your local health library for a copy of this article. Find you local health library.