Case study:

11 May 2010

Community Generalists Palliative Care Team in Bournemouth and Poole PCT

Key points

Bournemouth and Poole PCT has expanded its highly successful Community Generalists Palliative Care team, which helps palliative care patients in the Bournemouth area spend their last days at home rather than in hospital.

The team has facilitated around 240 deaths at home since it was created with lottery funding in 2003 and saved at least £250,000 through reduced hospital admissions.

Now the trust has expanded its scope from 8am-5pm on weekdays and four hours at weekends to 8.30am-9pm seven days a week as well as offering night sitting services where required.

It is anticipated that over the next year this will allow 300-400 deaths to be facilitated at home and many more hospital admissions avoided.

The Generalists Community Palliative Care Team provides palliative care for adults suffering with cancer and non-cancer conditions who wish to remain at home in the end stages of life.

The team was set up because Bournemouth did not have access to a community hospital or hospice beds so most palliative care patients would die in an acute hospital.

The original team was led by a community palliative care matron, supported by three WTE health care assistants and a part-time occupational therapist.

With the support of other statutory and voluntary agencies the team provided, among other things, holistic assessment of needs, support and reassessment visits, symptom control, assistance with personal care, respite sitting and bereavement support.

Patients and carers really appreciated the service the team offered.

During its first three years it provided direct care for 856 patients and 950 unpaid carers and facilitated 240 deaths at home at an estimated saving of £266,000.

It also reduced length of bed days because palliative care patients were discharged earlier.

But it also became clear that in the last year 52 patients were admitted to acute hospital beds who might not have needed to if the service was available for longer hours.

It was recognised the service needed to be expanded to seven days a week with night sitting services if required to prevent unplanned admissions whenever possible.

Recruitment to the new team began in September 2006.

A new, expanded team is now in place, overseen by the trust’s Palliative Care Operational Group.

Referrals to the team are from GPs, primary, secondary and intermediate healthcare professionals, social services and the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole NHS Hospital Trust which provides specialist palliative care services.

At present a business plan is being developed to provide a similar tailor-made service to meet the needs of patients in the Poole area.