Second phase of programme to improve emergency care at end of life is underway

Categories: Care.

After a successful pilot, Hospice UK and NHS Improvement have begun the second phase of their programme to help improve the quality of emergency care for patients who may be at the end of life.

The first phase of the Emergency Care Improvement Programme (ECIP) End of Life Care Project was carried out in 2017 by the Hospice UK Quality Improvement team in partnership with NHS Improvement and four acute trusts across England: Cambridge University Hospital, Brighton and Sussex University Trust, United Lincolnshire Hospitals NHS Trust, and Wirral University Hospital Teaching NHS Foundation Trust.

The programme’s aim is to enhance the care for patients who may be in their last three months of life, who attend or have been admitted to hospital in an emergency.

ECIP was developed because people are more likely to be admitted to hospital in an emergency towards their last days of life. According to research carried out in 2015 by the National End of Life Care Intelligence Network, 67 per cent of the total deaths in England had at least one emergency admission in the last three months of their life.  While many admissions are not avoidable, they might not be wanted by the patient and their carer. Additionally, research by the Nuffield Trust has found that hospital costs make up the biggest proportion of costs in end of life care.

The programme looked at challenges within each hospital, including prioritising patients’ wishes. In the case of Wirral University Hospital, as a result of the project the palliative care team now take daily positive action to support patients in achieving their preferences. Dr Catherine Hayle, who led on the programme, said:

“We were delighted to be offered the chance to join this project, which offered us a valuable opportunity to receive support with our improvement work from a variety of perspectives. For example, a colleague from NHS asked us to consider their ‘Red to Green Bed Days’ concept for our palliative care caseload, and then a colleague from Hospice UK supported us to translate this concept into ‘Silver to Gold Bed Days’ – an initiative which aims to ensure every day spent in hospital ‘counts’ for patients approaching the end of life.”

“We were also lucky to receive two site visits by Hospice UK colleagues, which provided an objective assessment of our progress and blind spots. I have no doubt that our participation in this project supported us in getting from a CQC assessment of ‘requires improvement’ for end of life care in 2016 to ‘good’ in 2018.”

Based on the programme’s success, NHS Improvement commissioned Hospice UK to carry out a second phase, and they are currently working with another eight hospitals around England, including Royal Cornwall Hospitals, Ipswich Hospital and University Hospitals of Leicester.

For more information contact Hazel Webb, Programme Administrator.


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