Case study:

11 May 2010

Implementing Preferred Place of Care for patients with heart failure and other long-term conditions in the North Trent Network of Cardiac Care

Key points

The North Trent Network of Cardiac Care is working to extend palliative care to patients with heart failure and other long-term conditions and enable them to choose where they wish to die.

Anecdotal evidence suggests that patients with long-term conditions do not have access to the same palliative care support as cancer patients, and that some staff caring for this group of patients do not see them as needing palliative care.

Another problem is that because of the disease trajectory of long-term conditions it is often difficult to predict when the last days of life will be.

One part of the network’s strategy involves training staff to help patients make an informed choice about where they wish to spend their last days.

With this in mind it recently held a network-wide PPC ‘Train the Trainers’ event attended by staff from tertiary, secondary, primary care, nursing home trainers, professional development staff, ambulance staff and out of hours staff.

Individual service development managers will then be responsible for driving forward PPC in their own health community.

In addition a long-term conditions palliative care group has been set up in Sheffield to help introduce end of life tools, including the PPC document, which the group felt would help staff recognise and address the needs of the patient.

So far over 25 staff in Sheffield have received PPC training and if the attendees cascade the training as agreed a total of 592 staff across the network will benefit.

Work is also under way to develop a Sheffield-wide end of life plan and introduce PPC and other tools in hospitals, the community and care homes.

The group is also spreading the message to GPs and ambulance trusts.

Discussions have taken place with the Single Assessment Process board to see how PPC fits in with the SAP process.

It is also awaiting approval by the Sheffield PCT clinical records group.

The long-term plan is to ensure all staff receives training on using the PPC and to embed the PPC document in all PCTs across the network.