Contacts
Contact:
Dr Charles Daniels
Medical Director
Organisation:
St Luke’s Hospice
Kenton Grange Kenton Road Harrow HA3 0YG United Kingdom
Tel:
020 8382 8001
Email:
Contact:
Susie Pemberton
Heart Failure Nurse Specialist
Organisation:
Caryl Thomas Clinic
Headstone Drive Harrow HA1 4UQ United Kingdom
Email:
Contact:
Tracey Allen
CNS Palliative CareHarrow Community Palliative Care Team
Organisation:
United Kingdom
Tel:
020 8382 8084
Email:
Case study:
04 December 2007
Palliative support for patients with advanced heart failure
Key points
- Patients with advanced heart failure in Harrow now receive comprehensive palliative care in the community
- The scheme gives patients improved symptom control quality of life and a greater say in where they die
- It has also led to fewer deaths in hospital.
Patients with advanced heart failure and their carers are now receiving comprehensive palliative care in the community thanks to a collaborative pilot scheme in Harrow.
The programme is a joint initiative between the Harrow community heart failure service, the Harrow community palliative care team, St Luke’s Kenton Grange Hospice and the Consultant in Palliative Medicine at North West London Hospitals Trust.
Started in 2003, the new approach gives patients improved symptom control and quality of life.
They also have a choice about where they are cared for at the end of their life.
The initiative has helped reduced the death rate in hospital from 75% to 31%.
Preparing the new strategy involved close collaborative working between all members of the multidisciplinary team.Heart failure nurses visited the hospice and day care and shadowed the community palliative care team.
Multidisciplinary meetings were also held to examine clinical incident reviews and reflect on what went wrong.
In addition tools were created to help community heart failure nurses refer appropriately and in a timely fashion to the palliative care team and a pathway was developed for all heart failure patients who needed palliative care.
Heart failure nurses can now ensure patients with palliative needs are discharged early from Hospital because they can demonstrate appropriate MDT support is available in the community.
Access to hospice care is also available if a home death is not possible for whatever reason.
In addition those struggling at home can take advantage of respite care.
Patients also have access to day care and complementary therapy.
It is now planned to work with the cardiologists in secondary care to develop a pathway for heart failure patients.
The team also want to involve district nurses in joint case management to minimise duplication and ensure closer working relationships.
Finally, it is hoped to develop an educational programme for GPs on the management of patients with advanced heart failure and other end of life issues, as there have been problems in getting some of them to prescribe relevant emergency drugs.
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