“Together for Health – End of Life Delivery Plan” was published in 2013 and provides a framework for action by Local Health Boards and NHS Trusts working together with their partners. It sets out the Welsh Government’s expectations of the NHS in Wales in delivering high quality end of life care, regardless of diagnosis, circumstance or place of residence in Wales. The Plan sets out clear ways in which the voice of the individual, supported by those closer to them, is heard and respected at the centre of the services they need.
The Delivery Plan sets out action to improve outcomes in the following key areas between now and 2016, most pertinent to the service provided by the In-house team of Conwy to the Local Health board centred on outcomes three and four:
- Delivering fast, effective care – People receive fast, effective person centred care in order to maintain quality of life for as long as possible
- Reducing the distress of terminal illness for patients and their families; patients entering the terminal phase of their illness and their families feel well cared for.
A Service Level Agreement has been in effect from September 2011 between BCUHB and CCBC to provide a domiciliary care service in support of the District Nursing Team to enable people in Conwy to die in their own homes if they so wished.
What’s Changed?
Since the initial pilot in 2011 the team have supported people across Conwy to die in their own homes. There has been a year on year increase in the number receiving support.
- 2012-2013, 69 people received support over 947days.
- 2013-2014, 102 people received support over 1552 days.
- 2014-2015, 121 people received support over 2119 days.
The district nursing team and the In-house team are co-located in Llanrwst, Llanfairfechan and Llandudno allowing for a rapid, coordinated response.
Staff working with thin the End of Life service receive training to support them in their work. To date 20 front line staff members have qualified to QCF Level 3 in End of Life Care, with a second cohort of training having commenced in March 2015.
What Difference Has it Made?
The positive difference this service has made to people at a critical time in their lives can be evidenced by the letter families and friends of the deceased person write to the team and other professionals following support from the team.
‘Please accept my profound thanks for the excellent professional care given to my late wife throughout these past 4 months. It was given readily, with great compassion, professionalism and a wonderful relationship with the patient. We were delighted that C, P, B found time to come to the funeral. They became a very important part of A’s life and all of our family owe them a great debt of gratitude. It may be unfashionable these days to say it, but all of them are in the right job.’
‘We would like you to know that the kind of care in which empathy, deep respect and humour which you have shown to B cannot be measured. It is people like you who make all this possible with the pride and motivation you clearly demonstrated in your work and for which we thank you from the bottom of our hearts. C and I have witnessed the flawless harmonisation between the various external services offered by the NHS and Social services, including the District Nurses, the carers and the Marie Curie team, and we are full of admiration at the professional and compassionate care each one of you has displayed. This must be voiced as loudly as possible because you merit recognition and we wish all the departments who govern your employment to hear it.’
‘We recently worked together to enable Mrs H to return with a joint funded care package. Mrs H wanted to be at home for as long as possible and her wish was always to return to the Hospice to die, when the time came. She died within a few short hours of her readmission into the Hospice last week therefore she really had been cared for at home for as long as really was possible. I think this a real credit to the staff who had cared for her at Llys y Coed.
I thought it would be nice to share this with you as it shows such a positive outcome for the work we completed together.’