Mount Vernon Cancer Network Population Needs

1. Mount Vernon Cancer Network Population Needs MVCN Specialist Palliative Care Group Proposals for Service Development

2. Background The Mount Vernon Cancer Network (MVCN) Population Needs Assessment commissioned in 2012. Aim - Identify priorities for palliative and end of life care in line with national priorities. The extensive report identified 60 recommendations: Split into specialist and generalist areas.

3. Identified principles The following principles should be considered when implementing the recommendations: Commissioners and providers should ensure that there are no barriers (such as age, culture or underlying disease) to accessing services Joint Commissioning between Health and Social Care.

4. Specialist Palliative Care (SPC) Priority Areas SPC In-Patient Facilities Explore reasons for different activity rates in the IPU’s to ensure that best use of resources can be made. Clarify referral patterns and admission criteria (including admission hours) to ensure equitable access to SPC IPU facilities across MVCN in line with weighted locality populations.

5. SPC Community Provision After the review of SPC 7 day working has been completed commissioners should clarify the catchment areas for the community SPC teams to identify any gaps / overlaps in provision. After the review of intensive home care nursing has been completed commissioners and providers should consider comparing the services to: Ensure equity across MVCN Explore/clarify why average length of care is so different and % of deaths in hospital are so different. Consider: Expansion of the specialist community teams to enable more people to die at home (including care homes). Expansion of the intensive home care nursing service to ensure maximum benefit and equitable access to reduce inappropriate hospital admissions and deaths.

6. Continuing Health Care/Hospice at Home Identify best practice for joint working between Continuing Healthcare and Hospice at Home Services to ensure integrated working of both services and commissioning of integrated Hospice at Home/Continuing Care packages.

7. Generalist Community Provision Complete a more detailed mapping of all the community services to ensure that people can access community nursing and sitting services 24x7 as appropriate. This should include a review of unmet night care needs to include Marie Curie overnight service District Nursing and Intensive Home Care Support. Agree service specifications for all home care support services. These should include access times and implementation of the MVCN Palliative Care Response Criteria (RAG tool).

8. Care Homes Consider ways of providing more specialist palliative care support to care homes.

9. Recommendations It is recommended that: The NSPCG is tasked to complete this work within the next 6 months. That it reports back to the MVCN Cancer Board and the Herts and Luton and South Beds EoL groups with it findings. The NSPCG requests additional resource to complete this piece of work.