St Christophers increases its focus on people with frailty

Last week marked a change in tempo at St Christopher’s in its attention and response to people with frailty in their last years of life.

The hospice has been involved in delivery of care for people with frailty for over seven years now through the development of a partnership approach in Bromley known as Bromley Care Coordination.

This is a different model of care, often provided over a sustained period of time, which has thrived and shown evidence of valuable outcomes: high home based death rates, reduced symptom burden and reduced admissions to hospital.

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However, we are painfully aware that our effort to date does not address the needs of this growing group of people at any kind of scale. Also, it focuses primarily on the clinical requirements of people with frailty, their families and carers, rather than the more holistic needs such as a requirement to achieve, to be connected and to enjoy life.

Furthermore, our current approach denies players, other than health and social care professionals, the chance to get involved and help to change the experience of the last years of life of those who live into late old age. Our current activities are designed to change this.

On Thursday 14^th October we hosted our first conference in the St Christopher’s Centre for Awareness and Response to End of Life entitled “Frailty and end of life: It’s time to act”.

The day drew in over 100 individuals from a broad range of specialities and areas of interest spanning older people’s services, primary care, mental health, palliative care, care homes, commissioning, parliamentary research, community action and more.

People living with frailty and their carers also contributed via a conversation with the audience.

Our ambition was to create a proactive and coordinated plan of action which draws in the ideas and commitments of a wide variety of individuals and organisations who recognise, and want to respond to, the growing challenge presented by people living with frailty, often for many years.

Reflecting on six provocations – presented by commentators and leaders in geriatrics, system innovation and community action, social services, policy and societal change – the participants identified areas of action and their relationships to each other.

In addition they had the opportunity to hear about work already under way at St Christophers to change clinical practice triggered by a two year project funded by the Burdett Trust for Nursing. Emerging opportunities focus on clinical developments, societal change, workforce development and more, supported by a commitment to more integrated and cross sectoral effort.

One day later St Christopher’s CARE hosted another day on frailty – specifically for clinical nurse specialists (CNSs) in palliative care and frailty services – to explore the complexities of their work, share their expertise, learn from each other and build evidence to inform clinical practice.

Using an approach heavily influenced by citizens’ assemblies, CNSs from England and Wales worked together to draw up statements of approach which will inform practice going forward. This is part of the Palliative Discovery Programme, also funded by the Burdett Trust for Nursing, which aims to support and develop palliative care CNSs from across the NHS and voluntary sector.

This programme of work has only just started and we are keen to invite many more people to participate.

To help with this a virtual version of the conference “Frailty and end of life: it’s time to act” will be made available in the coming few months to accommodate those who could not attend in person. To register your interest email education@stchristophers.org.uk .

And Palliative Discovery holds its launch conference virtually on the 25^thNovember open to CNSs and those supporting their work anywhere in the world. Go to https://www.stchristophers.org.uk/palliativediscovery  to find out more on this.

The key learning from both events was the requirement for broad, rich, inclusive conversations, thinking and action. Please join us to be part of them.