Case study:

11 May 2010

Respite Palliative Homecare Teams in Salford & Trafford

Key points

Respite palliative homecare teams in Salford and Trafford are enabling terminally ill patients to be cared for and die at home – regardless of diagnosis.

The homecare teams were originally set up after local studies in the two areas showed that as few as 21% of all cancer patients were dying at home.

But a year after their introduction a survey revealed that 80% of all patients visited died at home while three quarters of the remaining 20% died in the place of their choice.

Evaluation studies also showed the care provided was excellent and that all carers, professional and lay, benefited from the increased support provided.

Recently it was decided to extend the service from the last few weeks to the final year of life – and to provide support not only to patients but also their carers.

Within Trafford it was also decided to provide care overnight where necessary.

The two teams, which are funded by their primary care trusts in collaboration with St Ann’s Hospice, offer a combination of psychological and practical support, nursing care and advice that is supplementary and complementary to the existing community services.

They facilitate the discharge of palliative care patients from hospital or hospice, especially those whose preferred place of care is home, and provide support if either the patient or carer are facing a crisis

Each team consists of a full-time coordinator and team leader together with registered nurses and health care assistants.

Both are underpinned by an extensive bank of nurses who have experience in delivering palliative care at home.

The main challenge when setting up these services was the poor response from the district nursing teams.

This has been overcome by raising awareness and involving the DNs in decisions about service delivery and change.

The teams are now planning to expand their remit to a greater number of non-cancer patients.

Although care is provided to anyone with a life limiting illness only around 17% of all patients visited have a non-cancer diagnosis.

The professionals working in these clinical areas will be told about the service in the hope that raised awareness will lead to an increase in referrals.

Education and training will also be provided to all team members to ensure they are adequately equipped to offer appropriate support.