Palliative Care in Perth and Kinross CHP

1. Palliative Care in Perth and Kinross CHP Mrs Ann Gourlay Palliative Services Manager, Perth and Kinross CHP

2. Existing P&K Specialist Services • Consultant • 5 Community Macmillan Nurses • Day Care • Traditional Day Care - Tuesday, Thursday, Friday • Drop-In Day – Wednesday • Hospital Palliative Team Palliative Services, Perth and Kinross

3. Alison Morrison Consultant in Palliative Medicine Ann Gourlay Palliative Services Manager • MACMILLAN HOUSE DAY CARE AND DROP-IN DAY • Nursing • Medical • Physiotherapist • Occupational Therapist • Complementary Therapists • Social Worker • Bereavement Services Coordinator • Volunteers and Manager • COMMUNITY • Macmillan Nurses • District Nurses ROXBURGHE HOUSE Link Nurses Nursing Homes HOUSING AND COMMUNITY CARE PRIMARY HEALTH CARE TEAM COMMUNITY HOSPITALS • PRI (& NINEWELLS) • Hospital Palliative Team • Community Liaison Team • Clinical Nurse Specialists Residential Homes Marie Curie Delivering Choice Programme Palliative Services, Perth and Kinross

4. Existing CHP Service Development • Prevention of admission • Delayed discharge • Community Hospital redesign • Long-term conditions Palliative Services, Perth and Kinross

5. Strengths • Tested, integrated specialist model with: • Local links with social work • Nursing Homes step up, step down • CHP • GPs, DNs, Specialists • Redesign of Day Care/Drop-In Day • 5 Community Hospitals • Hospital discharge – Community Liaison Team • Education • Includes: Introduction to Palliative Care Course, Syringe Driver Training (rolling programme), Education Evenings, Pre-Reg Nurse Training, Journal Clubs, GP Registrar Training Palliative Services, Perth and Kinross

6. Challenges • Rising numbers of elderly population • Delivering palliative services equitably between Perth City and rural areas • Out of Hours • Partnerships and communications Palliative Services, Perth and Kinross

7. Opportunities • New hospice • Public Involvement • Patient and health care professional satisfaction surveys • Advanced Nurse Practitioners • Partnerships • Macmillan Cancer Support • Marie Curie • Joint Planning Group • Liverpool Care Pathway Palliative Services, Perth and Kinross

8. Threats • Fragmentation • Lack of resources at time of need to maintain patient in place of choice • Equipment shortages/delivery at time of need • Flexible resources to meet needs Palliative Services, Perth and Kinross

9. G A P S • Out of Hours • Medical • Nursing • Flexible resources • Rapid access to equipment • Transport • Speedy access to social support Palliative Services, Perth and Kinross

10. 2009 Picture • 10-bedded inpatient unit integrating • Day Care • Drop-In Day • Education facility • Also on site • Community Macmillan Nurses • Hospital Palliative Team • Medical Team • Management • Admin Palliative Services, Perth and Kinross

11. Alison Morrison Consultant in Palliative Medicine Ann Gourlay Palliative Services Manager • CORNHILL SITE INPATIENTS, DAY CARE AND DROP-IN DAY plus EDUCATION FACILITY • Nursing (including Community and Hospital Macmillan Nurses and Palliative Day Care Leader) • Medical • AHP Support • Complementary Therapists • Social Worker • Bereavement Services Co-ordinator • Volunteers and Manager COMMUNITY District Nurses Link Nurses HOUSING AND COMMUNITY CARE COMMUNITY HOSPITALS PRIMARY HEALTH CARE TEAM • PRI/NINEWELLS • Community Liaison Team • Clinical Nurse Specialists Marie Curie Delivering Choice Programme Residential/ Nursing Homes Palliative Services, Perth and Kinross