Issue - meetings

1.1.        The Committee considered a report on the progress of East Sussex Healthcare NHS Trust (ESHT) End of Life Care (EOLC) project.

1.2.        Catherine Ashton, Director of Strategy, and Hazel Tonge, Deputy Director of Nursing, both from ESHT, answered questions from HOSC Members.

New EOLC team structure

1.3.        Hazel Tonge explained that the new EOLC team structure – including the Senior Nurse who will coordinate and oversee the EOLC service across both hospital sites – came together in May and is currently focussed on making sure the right governance arrangements are in place to ensure both the Conquest Hospital and Eastbourne District General Hospital (EDGH) team work to the same standards. There is currently not enough available data to demonstrate success of the new arrangement, but in two months’ time there should be. The two teams have, however, said that they are now functioning as one team, have access to the same specialist support, and are supporting each other.

1.4.        Hazel Tonge explained that EOLC Practice Development Facilitators have trained 1,065 acute ward staff on the new Individualised Care Plan. A patient’s individualised care plan includes symptom controls and their preferred plan for death, and also includes where to refer them within the healthcare system.

Culture and leadership

1.5.        Hazel Tonge explained that staff have told her that there is a very different culture in the organisation than there was two years ago. Staff now feel secure enough to seek support and raise concerns – for example, through weekly nurse meeting groups – or access counselling should they require it. The NHS Staff Survey results reflect this observation.

Extending the service to 24/7

1.6.        Hazel Tonge said that she has written a draft options paper for the ESHT Board to consider setting out the advantages and disadvantages of maintaining a 5 day service or moving to a 7 day one.  The Trust Board will consider it during July and decide on the necessary financial support.

Identifying patients in the last year of their life

1.7.        Hazel Tonge said that ESHT’s priority currently is to identify those patients in the last days of their life. The EOLC teams are working with non-palliative teams, such as cardiology and gastroenterology, but the process is not yet complete. There is an awareness and engagement workstream in place to raise clinicians’ awareness of palliative care, but raising awareness is a nationwide challenge – which is why so much national guidance is written on the subject.

1.8.        Jessica Britton said that the ESBT Alliance is developing an EOLC Strategy. This involves ESHT working with CCGs to develop a system where staff from primary, community and acute care can share information about patients who are in the last year of their life, with their consent. The EOLC Strategy will also develop awareness raising programmes and training courses to assist clinicians to identify those patients in the last year of their life. Further details of the strategy are likely to be available by next year.

1.9.        Catherine  ...  view the full minutes text for item 6