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Alternatives to hospital for end of life care Tom Bowen The Balance of Care Group www.balanceofcare.com NAO End of Life

The Balance of Care Group. Alternatives to hospital for end of life care Tom Bowen The Balance of Care Group www.balanceofcare.com NAO End of Life Care Conference, London, 17 June 2009. The Sheffield study for NAO. Support and participation of

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Alternatives to hospital for end of life care Tom Bowen The Balance of Care Group www.balanceofcare.com NAO End of Life

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  1. The Balance of Care Group Alternatives to hospital for end of life careTom BowenThe Balance of Care Groupwww.balanceofcare.comNAO End of Life Care Conference, London, 17 June 2009

  2. The Sheffield study for NAO • Support and participation of Sheffield University Teaching Hospitals NHS Foundation Trust Sheffield PCT St Luke’s Hospice Sheffield City Council • Anonymised retrospective survey of hospital casenotes of people who died in Sheffield in October 2007 • Additional linked data sets

  3. Three major themes • Where did patients die? • What were the characteristics of the patients who died? • What can be done to change the patterns of care?

  4. Other Risk Factors • Living alone 76 (22%) • Housing 7 (2%) • Carer Incapacity 18 (5%) • Dementia diagnosis 65 (19%) • Confusion 43 (12%) (no dementia specified)

  5. Contacts near the end of life • Chaplaincy (13/200 dying in hospital) • Community palliative care (65/104 with cancer) • Heart failure nurses (4/47) • COPD nurses (8/67) • Social care (138/147 frailty patients)

  6. Shared IT Common Data Risk registers Oncology team Surgeon Geriatricians Psychiatrists Primary Care teams Community Nurses Community Rehab Voluntary Organisations Cancer Patient at End of Life Cancer Charities Pain/Symptom Control team Frail Patient at End of Life Home care Nursing Homes Social Care Equipment Community Pharmacists Psychology Chaplaincy & Faith services Palliative Care teams Community matrons Carers Intermediate Care Hospices Carers Palliative Care teams An Integrated Model for End of Life Care Specialist medical teams Home care Specialist nurses Patient with Chronic Disease at End of Life Nursing Homes Carers Palliative care teams

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