Hospices have increasingly been employing technology to provide care in innovative ways, something that Covid-19 has accelerated. Whether online consultations or bereavement support via Zoom, it’s clear that virtual hospice care is here to stay.
The virtual ward
St Helena Hospice in Essex has partnered with local home care provider Bluebird Care Colchester and Tendring to provide a virtual ward to patients and families in the comfort of their own homes.
The SinglePoint Virtual Ward enables patients to receive similar personal care from healthcare assistants as they would at the hospice, but at home, freeing up valuable bed space at the local hospital, as well as clinicians’ time.
Melvyn Plum, Managing Director of Bluebird Care Colchester & Tendring, explains how it works: “By utilising the latest cloud-based technology, we are able to streamline the referral process which allows an immediate response so we can put the care and support in place straight away.
“Our care assistants are rigorously trained to provide a unique service of personalised care, from check-in visits through to full live-in support, so we are perfectly matched to assist St Helena Hospice and help our local community.”
Jo Tonkin, St Helena Hospice’s director of care, adds: “Our virtual ward has expanded significantly since we launched the service last year, and has evolved further because of the pandemic with the number of beds growing from 8 to 14 in the last few weeks.
“This has also allowed us to change our model of care, increasing the level of support we can provide. We are now able to visit patients up to three times a day, or more if necessary, depending on an individual’s need. We can now also support people for up to four weeks, whereas before the pandemic, it was up to two weeks.”
The specialist knowledge platform
St Mary’s Hospice in Cumbria is also implementing a virtual platform, but in their case the aim is to ensure they have adequate consultant cover.
Working with Supportive Care UK Ltd (SCUK), a company that offers consultant-led specialist palliative care services across the UK, the new model will see St Mary’s team access senior consultants using the virtual platform during normal day-time working hours, and by telephone for advice out-of-hours (evenings, nights and weekends). The day-time support will consist of a consultant-supported weekly multi-disciplinary team meeting with the hospice clinical team, and two consultant-supported ward rounds, during which each patient’s care and treatment will be discussed and reviewed.
The hospice decided to deploy the virtual platform after recruitment activity was impacted because of the national shortage in the number of palliative care doctors available.
Jo Blake, Head of Clinical Services, explains the platform’s benefits: “Speciality doctors are able to care for and treat the majority of patients who access hospice in-patient care. However, some patients have more complex needs and for these, the doctors need access to medical advice from a senior palliative doctor. This access is not available from St Mary’s local NHS Trust (Morecambe Bay) as there are palliative consultant vacancies in the locality. To help resolve this situation we are evolving our way of working by teaming up with Supportive Care UK so they can provide our consultant cover.”
The centralised record system
In Exeter and Devon, an online clinical record-keeping system called SystmOne has been pivotal to the provision of end of life care.
The centralised system used by healthcare professionals across the UK was implemented by Hospiscare between October and November 2019, enabling information to be shared seamlessly with local hospitals and GP practices. It enables GPs to see Hospiscare records for their patients including Advanced Care Planning information, while nurses and doctors at the hospice can access the most up-to-date information for their patients, such as pathology results and prescribed medication.
More recently Hospiscare extended its record sharing permissions to include the Supportive and Palliative Care Team at the Royal Devon & Exeter Hospital. The clinical staff in the department can access patient records on a view-only basis to enable them to work more closely with Hospiscare.
With the hospice now caring for most of their patients at home, the new system has been particularly effective as it allows links with the community nurses and reduces the risk of errors and inaccuracies.
Additionally the hospice uses AccuRx, secure video calling software which integrates with SystmOne. It lets hospice doctors and nurses communicate face-to-face with patients and carers without putting patients and staff at risk of contracting Covid-19.
The Zoom bereavement support meetings
When the pandemic caused St Giles Hospice to put its Bereavement Help Points (BHP) on hold, the West Midlands hospice had to re-think how it could deliver bereavement support to the community.
The BHP model was initially developed at St Giles Hospice and has been adopted by a number of other hospices, including St Christopher’s in south London. The Help Points provide information and support within communities to widen access to bereavement support for local people.
The challenge of ensuring that people were still supported prompted St Giles to offer virtual bereavement help points via Zoom, building on the success of its network of 14 help points held in the community. Ian Leech, the hospice’s community engagement manager, said the idea for the virtual help points came about very quickly after the lockdown began. “We knew just how important community based bereavement help points are in providing an anchor point for people’s weeks in the days, months and years after bereavement,” he said.
“Prior to the closures we were seeing more than 1000 visits every month, with help points every day of the working week, across our catchment area. Offering an online option seemed the next step for existing bereavement help point attendees and newly bereaved people who would like some peer support.”
The hospice has launched two virtual help points for people who already attend groups, along with a third for newly referred people.
“We initially spoke to the volunteers who help run our help points to ask them to help us test the technology and the format of the groups so they were involved in the pilot Zoom meetings” Ian said.
“Their willingness to embrace the technology was wonderful, particularly as we have a large number of volunteers who are over 75 and the levels of engagement really challenged people’s perceptions of what older people are capable of when it comes to technology.
“Virtual help points also present a real opportunity for the future which we can and will explore more, particularly around creating evening help points, but also around reaching people who are physically isolated, ill or unable to travel.”