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Clinically Based Education and Training Initiative

Clinically Based Education and Training Initiative. Dr Linda Wilson (Consultant, AWC) Liz Price (CNS, Bradford) Wendy Laycock (Facilitator, AWC). PCTs CCG reconfiguration Airedale hospital –started GSF for acute hospitals programme

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Clinically Based Education and Training Initiative

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  1. Clinically Based Education and Training Initiative Dr Linda Wilson (Consultant, AWC) Liz Price (CNS, Bradford) Wendy Laycock (Facilitator, AWC)

  2. PCTs CCG reconfiguration Airedale hospital –started GSF for acute hospitals programme Airedale hospital -Transforming community services, EOL as 1 of 5 workstreams -EOL strategic group EOL Pathway developed Health Foundation Shared Purpose Project Communication skills training (Sage and Thyme) EPaCCS Gold Line System 1 adopted within Airedale Hospital and all GP practices in AWC (16/17, last one May 14) Non-recurrent funding bid for GSF in 30 Care Homes Background Scene 1 Airedale AIREDALE,WHARFEDALE AND CRAVEN (AWC) END OF LIFE PATHWAY Dr L Wilson/ AGH EOL group ASSESS Holistic assessment (advance) care planning NICE QS3 SUPPORT & COORDINATE CARE Physical, psychological, social, emotional, financial, and spiritual support. Access to drugs and equipment, 24/7 . Reduce avoidable hospital admissions and shorten number of bed days NICE QS4, 5, 6, 7,8, 9, 10 CARE AFTER DEATH and BEREAVEMENT NICE QS 12, 13, 14 DISCUSS NICE QS2 IDENTIFY Likely prognosis ≤ 12 months, add to GSF register NICE QS1 LAST DAYS OF LIFE NICE QS 11 CARER SUPPORT STAFF SUPPORT AND EDUCATION NICE QS 15,16 INFORMATION FOR PATIENTS AND CARERS SPIRITUAL CARE SOCIAL CARE

  3. Synergy: Several individual events coming together GSF in 30 Care homes GSF Airedale Hospital Going for Gold in 12 GP practices CCG reconfiguration System one across care settings /EPaCCS • Communication Skill training • Sage and Thyme • Difficult Conversations Training Telehealth hub / Gold Line

  4. Background 2 • Managed Clinical Network (MCN) • Non recurrent funding for Gold Standards Framework (GSF) in 30 Care Homes and subsequently in Going for Gold in 12 GP Practices • National Transforming End of Life care in acute hospitals programme

  5. Background 3: Bradford Hospitals • Pilot Last Year of Life Project • Baseline audit • 4 Workstreams developed to implement project • Identification of patients in the last year of life • Discharge & SystmOne – sharing information • Education • Patient & carer experience • Roll out across Trust • Repeat audit

  6. How we used the MPET Funding • GSF facilitator Airedale Hospital • GSF facilitator AWC community • GSF facilitator Bradford community • Incorporated to Specialist Palliative Care CNS role in Bradford Teaching Hospitals Facilitators promoting GSF as a way to encourage Identification, Assessment and Planning of Care

  7. MPET in Community Posts Audit and evaluation EPaCCS Template training GP’s /DNs / Practice teams Communication Skills training Supporting GSF meetings Gold Line Service • Baseline questionnaires and data • GSF Good Practice Guide • EPaCCS training-EOL template for all practices • 2 day Mandatory training DNs and others

  8. Key Outcomes so far • Airedale /Bradford Community • EoLC Template training -194 nurses and 42/87 GP practices • Articles and information at events • GSF meetings attendance, 17 registered for Going for Gold • Airedale Hospital • Audits- LYoL, MPET • Increasing confidence to identify and offer ACP • Flag system and increased liaison of EoLC information • Bradford Teaching Hospitals • Increased number of patients identified as being in their last year of life • Greater sharing of information across primary & secondary care • Communication skills sessions for senior clinicians

  9. Lessons learnt • A vision for the whole pathway but broken down into manageable parts • Joining up primary and secondary care • High level “buy in” – executive support from hospital; commissioner involvement • Communication- consider all stakeholders

  10. Lessons learnt cont… • Persistence and resilience • Engaging staff / knowing your audience • Collaboration: within and between organisations • Data to support, convince and provide ongoing funding • Be realistic!

  11. Challenges/Future issues • Keeping the dream alive • Education, Education, Education – competencies??? • Media misinterpretation of LCP etc… • Social Care agenda still to address • Short term non-recurrent funding

  12. How do you eat an elephant ?

  13. Questions?

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