Case study:

02 February 2009

Complex and Palliative Continuing Care Service (CAPCCS) in Leeds

Key points

The Marie Curie Delivering Choice Programme has teamed up with NHS Leeds to set up a Complex and Palliative Continuing Care Service providing integrated health and social care to people at the end of their life.

The service, which is part of the Leeds-wide district nursing service, is provided by a team of 18 specially trained health and personal care assistants who offer increased choice and support to patients wishing to die at home.

Integrating health and social care as one single service has helped improve the quality and continuity of care for patients as well as the coordination of community care for district nurses. The number of patient safety incidents has also decreased as a result.

So far 229 patients have been supported by the new service, which was launched in January 2008. In its first 10 months it made 5,325 visits to patients in their homes with each visit lasting an average of 50 minutes.

The CAPCCS team consists of a service lead, two senior nurses, 18 care assistants and two clerical support officers. A staff nurse has also been appointed to support the care assistants’ ongoing development.

All care assistants receive an intense induction to ensure they have a thorough understanding of the care needs of patients at the end of life as well as their families and carers. The team meets daily to share updates on patients receiving the service and is also in constant touch with the district nurses. Work is only allocated to the care assistants after consultation with the district nurses.

Following the launch of the service a series of workshops were set up to inform district nursing teams of the service, how to refer patients to it and the level of care that will be available for their patients.

The Marie Curie programme has attempted to underline the value of the service as well as the close involvement of district nursing through regular awareness-raising events as well as face-to-face meetings.

Recruiting the team was also challenging. To begin with advertising was carried out internally through NHS Leeds but it was later found that advertising in the local newspaper produced better results.

Another challenge has been finding suitable accommodation. A proposal has now been agreed for the staff to be based in a new location which is relatively central in the city. This will be a more effective use of resources, reducing the amount of travelling time.

The Marie Curie Delivering Choice Programme is funding nine of the care assistants until the end of the pilot in September 2009 with the rest of the funding coming from NHS Leeds. The service is expected to continue after this time with Leeds NHS taking on the full costs.

The service is currently being monitored by the service lead and the Leeds project’s Operations Manager. Feedback is being sought from patients, carers and district nursing teams that used this service. It is also undergoing independent evaluation by Lancaster University.