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Helping people choose where they die while cutting social work admin

A service that coordinates care at the end of life is enabling more people to die at home and reducing hospital admissions while also cutting administration for social workers, says its manager, Heather McBeth.

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More than half of all deaths in England and Wales occur in hospital, even though most people would prefer to die at home. Well-coordinated end-of-life care can improve patients’ quality of life, reduce unnecessary and avoidable hospital admissions and help more people die in their place of choice. 

Earlier this year, South of Tyne and Wear NHS launched a new Palliative Care Coordination Centre with patient choice in mind. The service is designed to improve coordination of end-of life-care across the area by providing a one-stop-shop for social and healthcare professionals and patients and carers alike. Marie Curie Cancer Care manages the service, arranging and coordinating bespoke care packages and equipment for people who are terminally ill and need care and support at the end of their lives.
Single contact point for professionals and families

Our team is made up of a service manager and four care coordinators, and we also have access to a Marie Curie clinical lead nurse, who is on hand to offer advice to the team. We act as a single point of contact for the referrer, patient, family, carer and care provider. All our referrals are planned and come from social care and health professionals. They assess the needs and wishes of a patient as early as possible and look to us to put together the most suitable package of care for them, working closely with local providers. 

Our job is to make sure people have access to the right services and support based on their individual needs. And because the services are coordinated from one place, we can ensure that the most suitable type of care is in place, there is no duplication and resources are managed effectively. For example, our care coordinators hold weekly meetings with social work or health professionals to discuss and update care and to ensure the changing needs of patients and carers are at the forefront of decision making. 

Cutting down admin

The service crucially cuts down the amount of time spent by social care and health professionals on the administrative side of arranging care, leaving more time for them to focus on patient care.

In the first six months of the service over 3,000 interventions have been made to 164 patients. Our work has ranged from organising urgent discharges from hospital to a patient’s place of choice, to providing more specialised care for patients with motor neurone disease, Parkinson’s and advanced stages of dementia. 

Fewer hospital admissions, more deaths at home

The service has reduced the number of unnecessary emergency admissions to hospital, and 86% of our patients have died at home, where they wanted to be, with the support in place to make it possible.

We are learning all the time and are closely monitoring the demand for and capacity of local services. We identify any gaps in provision and report back to the local commissioners. Although its early days, we’re impressed with initial results which show a positive impact for social and health care professionals and local people at the end of life. 

The Social Care Institute for Excellence recently launched their film on the coordination of services at end of life, which includes interviews with people involved in the Palliative Care Coordination Centre and those who have experienced support from Marie Curie services. 
For further information about the Palliative Care Coordination Centre email Heather McBeth.

Mithran Samuel

About Mithran Samuel

Mithran Samuel is adults' editor at Community Care.

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