WELCOME

Tuesday 28 April 2015 WebinarHealth Promoting Palliative Care &

Developing Compassionate Communities

Health Promoting Palliative Care & Developing Compassionate Communities

Tuesday 28 April2015

12.30pm – 1.30pm

Libby Sallnow, Palliative Medicine Doctor

Julian Abel, Palliative Care Consultant,

Weston Area Health Trust & Weston Hospicecare&

Beverley MatthewsLTC Programme Lead, NHS Improving Quality

Bev MatthewsA nurse by background, Beverley has worked extensively throughout the NHS in a variety of clinical, managerial and strategic roles. Beverley’s current role as Programme Delivery Lead for Long Term Conditions Improvement Programmes: LTC Year of Care Commissioning Model and LTC Framework. Prior to joining NHS Improving Quality in April 2013, Beverley was Director of NHS Kidney Care and NHS Liver Care.

Passionate about service transformation through developing networks and leading complex programmes. Providing strategic leadership to partners within health communities, managing stakeholders and working across agencies.

Julian Abel, Palliative Care Consultant, Weston Area Health Trust & Weston HospicecareAreas of interest are compassionate community development in end of life care, electronic palliative care coordination systems, widespread use of advance care planning, use of quality improvement methodology in end of life care, and more recently development of a hospital treatment escalation plan. Contributed to the National End of Life Strategy implementation, Transforming End of Life Care in Acute Hospitals and currently working with the National End of Life Care Intelligence Network on developing end of life reports that can be used for continuous quality improvement..

Libby Sallnow, Palliative Medicine DoctorUndertaking a PhD in community engagement in end of life care. Research Fellow at St Joseph’s Hospice, London. Doctoral student at the University of Edinburgh. Research interests include a public health approach to end of life care, the role volunteers can play in end of life care, benefits of collaboration for communities and hospices, developing new models of engagement and compassionate communities. Libby has experience of working with innovative programmes exploring these issues both in the UK and internationally and has published books and articles on this field.

Meet the Speakers

Health Promoting Palliative Care &Developing Compassionate Communities

• Understanding the drivers for and evidence supporting community development in health and social care.

• Understanding how this approach has been applied to end of life care.

• Learning about the Compassionate Cities Charter and how this may be implemented locally.

of Care foundation.

Learning Outcomes

Beverley Matthews

LTC Programme LeadNHS Improving Quality

Beverley.matthews@nhsiq.nhs.uk

LTC Year of Care Commissioning Programme:

• 5 Early Implementer sites

• 35 Fast Followers

• Whole Population Datasets

• Implementation Guide

• Simulation Modelling

• Specialist Support Team

LTC Person Centred CareImprovement Programme:

• 40 Early Implementer sites

• 4 regional learning networks

• Snapshot Survey

• Simulation Modelling

• Specialist Support Team

Long Term Conditions Learning Community

• LTC Dashboard

• Case Studies

• Lunch and Learn Series

• The Bulletin

• Specialist Support Team

@NHSIQ @bev_j_matthews #LTCimprovement #LTCyearofcare

To pre-register email LTC@nhsiq.nhs.uk

LTC Lunch & Learn Series ….coming soon…

Date Webinar Hosted by Bev Matthews &

29 April 201512:00 – 13:00

Information Sharing for Care Coordination Adam Hatherly, HSCIC&

Christine Wike, NHSIQ

1 May 201512:30 – 13:30

Information as a Therapy Mark DumanMRPharmS DirectorMonmouth Partners

6 May 201512:30 – 13:30

Prevention & Effective Interventions inFrailty

Helen LyndonNurse Consultant Older People, Clinical

Lead Frailty, NHS England

27 May 201512:30 – 13:30

Primary Care Workforce for the 21 Century Webinar

Sharon LeePrimary Care Workforce Facilitator

South Kent Coast CCG

4 June 201512.30 – 13.30

Home Checks/Prevention Peter O’Reilly & Geoff HarrisManchester Fire & Rescue Service

9 June 201512 noon – 1pm

Health 1000 Rob MeakerBarking, Havering & Redbridge

Community development in end of life care

Libby Sallnow and Julian Abel

Why has community development become the new buzz word?

Drivers for change:

• Recognition of limitations of professional knowledge

• Communities possess answers

• Demographic and funding pressures

• Appreciation of the impact of social factors on health and wellbeing

• Top-down approaches often do not lead to sustainable change

• Upstream interventions can have significant impact

• Health is everyone’s responsibility

The evidence base is now building

• Having a poor social network is as dangerous as smoking 15/day– Social relationships and mortality risk: a meta-analytic review. Holt-Lunstad et al.

(2010) PLoS Med

• Having a strong social network in LTC results in significant cost savings in formal care and improves mental and physical wellbeing– The contribution of social networks to the health and self management of patients with

long-term conditions. Reeve et al. (2014) PLOS One

• There is solid evidence that engaging communities has a positive impact on health outcomes, behaviours, self-efficacy etc.– Community engagement to reduce inequalities in health: a systematic review, meta-

analysis and economic analysis. O’Mara-Eves et al. (2013) Public Health Research

Community development and end of life care

• Kellehear first described the ‘public health approach to end of life care’ (1999)

• Aligned the two apparently paradoxical disciplines of EOLC and public health

Compassionate Communities are community development initiatives that actively involve citizens in their own end-of-life care

Build partnerships between services and communities to build on the strengths and skills they possess, rather than replacing them with professional care

Surge in interest in

the UK

Severn Hospice Community Development Project

Reduced GP appointments. 44%

. Reduced A&E attendance. 30%

Reduce hospital admissions. 60%

Reduced Shropdoc calls. 30%

Reduced the cost associated with dependency. unquantified

Improved health and well-being for patients and carers, initial evaluation

120%

Total Emergency Hospital admissions

0

2

4

6

8

10

12

14

16

18

6/12 prior how many emergency

admissions

6/12 post how many emergency

admissions

Series1

Total of Home visits

0

10

20

30

40

50

60

70

6/12 prior to coco how many home

visits?

6/12 post coco how many home visits?

Series1

Total A&E Attendances

0

1

2

3

4

5

6

7

8

9

6/12 prior to coco how many A&E

attendances

6/12 post coco how many A&E

attendances

Series1

Total visits to practice

105

110

115

120

125

130

135

6/12 prior to coco how many practices

visits?

6/12 post coco how many practices

visits?

Series1

What are the problems?

• Addiction to high cost professional services and failure to imagine new ways of working

• Dying from a chronic illness, including frailty, is a speeded up form of aging

• Main problems of people are loss of mobility, loss of a role, loss of sense of meaning and value, with increasing social isolation

• These problems cannot be addressed using professional services alone

• The solution lies in supporting, enabling, encouraging communities to look after and value their elderly, frail, dying and those who are bereaved.

THE COMPASSIONATE CITY - CHARTER -

Compassionate Cities are communities that recognize that all natural cycles of sickness and health, birth and death, and love and loss occur everyday within the orbits of its institutions and regular activities. A compassionate city is a community that recognizes that care for one another at times of crisis and loss is not simply a task solely for health and social services but is everyone’s responsibility.

THE COMPASSIONATE CITY - CHARTER -

Compassionate Cities are communities that publicly encourage, facilitate, supports and celebrates care for one another during life’s most testing moments and experiences, especially those pertaining to life-threatening and life-limiting illness, chronic disability, frail ageing and dementia, grief and bereavement, and the trials and burdens of long term care are not the limits of our experience of fragility and vulnerability. Though local government strives to maintain and strengthen quality services for the most fragile and vulnerable in our midst, serious personal crises of illness, dying, death and loss may visit any us, at any time during the normal course our lives. A compassionate city is a community that squarely recognizes and addresses this social fact.

THE COMPASSIONATE CITY - CHARTER -

Allan Kellehear/draft/30.1.14

Our city will establish and review these targets and goals in the first two years and thereafter will add one more sector annually to our action plans for a compassionate city – e.g. hospitals, further & higher education, charities, community & voluntary organizations, police & emergency services, and so on.

This charter represents a commitment by the city to embrace a view of health and wellbeing that embraces social empathy, reminding its inhabitants and all who would view us from beyond its borders that ‘compassion’ means to embrace mutual sharing. A city is not merely a place to work and access services but equally a place to enjoy support in the safety and protection of each other’s company, even to the end of our days.