Find Your 1% Campaign Identifying people within the last year of life-

1. Find Your 1% Campaign Identifying people within the last year of life- Caroline Flynn End of Life Care Service Improvement Lead for Community & Social Care Services

2. Facts • Within the next hour, approximately 8 people will have died in a place not of their choosing, probably a busy hospital ward • Many will have up to 3 unplanned admissions during the last year of life • The last of these admissions may have lasted between 8 and 28 days • On average less than 3 out of 5 people die where they usually live. • Early identification, honest conversation and a clear plan helps most people remain safely in their own bed with people they know with them • 50,000 deaths per year rising to 530,000 by 2030 (NCPC 2011)

3. Overview of National Campaign Launched in 2011 Supports the following outcomes; • The opportunity for people to choose where they die, how they want to be supported and for that choice to be respected • Increase in people being identified as in the last year of life and use of a coordination system e.g EPaCCS • Changes in GP attitude, behaviour and increased confidence to identify the 1% of people who are likely to die in the next 12 months in their practice and enable a good death

4. North West Aspiration 10% of GP’s in the North West to participate in the campaign The number of people on the registers will increase from a baseline position towards a suggested level appropriate for that practice There is a North West ‘How to manage your register guide’ A consistent approach across the NW in establishing EPaCCS Every GP practice using GSF to be operating at level 4 in line with the NW level descriptor

5. National End of Life Care Programme Dying Matters Coalition North West Operational Group MCPEoLCN/GMCCN/CLEoLCN MCPEoLCN 8 Integrated Clinical Networks Warrington Wirral W. Cheshire Whiston Halton WLSF Aintree Liverpool

6. Merseyside & Cheshire Network The regionally agreed MPET priorities for which the network has to produce a plan and deliver against are Early identification of people within last 12 months of life with 10% of GPs within the NW signing up to the national campaign to find and increase the numbers of patients on their supportive care registers to 1% Supporting people to die in their usual place of residence % increase from baseline 2011 to 2015 Improving end of life care in acute hospitals enabling a % reduction in hospital deaths by 2015 Building confidence and capabity within the workforce to implement Advance Care Planning Develop leadership skills in clinicians working in palliative and end of life care

7. GP’s Workload- Causes of deathAverage deaths in a year - 20 per GP A 5-7 5 Cancer Organ failure B 1-2 Sudden death 6-7 Dementia,frailty and decline C

8. Breakdown of Deaths 2007-2010

9. 2011 Audit of GSF in Primary Care

10. GSF in Primary Care -Level Descriptor

12. Patients Increased satisfaction in end of life care provision- fewer complaints Equity Time to build relationships & trust Access to financial help Coordinated care Fewer admissions to hospital Health professionals Job satisfaction in providing good end of life care-fewer complaints received Equity Time to build relationships & trust Increased team working Active planning decreases crisis interventions Meeting the requirements of QOF Benefits to finding the 1% and implementing GSF Level 4

13. QIPP And The 1% Campaign

14. How do we deliver an equitable service?

15. We are nearly there…… District Nurses CNS Community Matron AHP Hospice Acute sector Care Homes The Patient and Family/Carers Audit Education Organisational Commitment GP Practice Commissioning

16. Thank you for listening www.dyingmatters.org/gp www.goldstandardsframework.org www.mccn.nhs.uk