Case study:

11 May 2010

Palliative care rapid response service across care settings in Luton

Key points

A rapid response team of NVQ level 3 nursing assistants with specific palliative care knowledge and experience has been set up in Luton to help end of life care patients and families in crisis.

The team, which supports the generalist palliative care workforce in both hospital and the community, offers a rapid response service from 8am to 6pm – which is to be extended to 11pm in February 2009.

The service is managed by Specialist Palliative Care but works with generalist teams and receives most referrals from generalist staff. The team also takes direct referrals and self manages its time and how long staff stay with a patient.

The service is supernumerary and is contactable by the district nurse, GPs, hospital discharge team and hospice team. Staff are expected to visit within half an hour of contact.

In its first year (2007-8) there were 78 referrals to the service and it is expected this will increase significantly in 2008 -09.

All patients known to the palliative services are given a red, amber or green status which helps communication between teams and has enabled staff to identify and, if necessary, prioritise patient visits and plan the day’s work.

There remain challenges, particularly in ensuring the service is available at any time between 8am and 6pm while at the same time maintaining skills and job satisfaction when the service is not required. As level 3 assistants the staff also need training and support to work alone.

When they are not required to visit clients the staff work in the local hospice, thereby developing their palliative skills. They also receive mandatory and palliative training using the local palliative care training programme. They also have weekly support meetings with the manager of the service as it is recognised that the daily challenges are unique to this service.

It is hoped in future to expand the service to 24 hours a day. There are also plans to introduce a more structured referral system and formally audit and evaluate the service.