The OneResponse service was developed to improve the local coordination of palliative and end of life care services and avoid unwanted or unnecessary hospital admissions. The service operates 24 hours a day, 365 days a year, across Basildon, Billericay and Thurrock.
The team work closely alongside St Luke’s long established hospice at home service, in partnership with North East London Foundation Trust, Community Macmillan Team and Community End of Life Care Team, together with other providers such as Marie Curie Cancer Care.
Over its initial three months, the OneResponse team handled over 3,500 calls, with the number of calls increasing each month.
All clinical calls are triaged by healthcare professionals and acted upon appropriately – this may involve giving advice and support or making a ‘rapid response’ visit. These visits are either made by one of the team, or a community colleague such as a district nurse, within two hours of the call being received.
The majority of calls received have come from family members seeking advice and help, and a good proportion of calls have also come from clinical professionals.
A total of 954 referrals have been made to the service. A total of 82 hospital admissions have been avoided and 174 ‘rapid response visits’ have been made to patients’ homes within 2 hours of OneResponse receiving the call.
OneResponse is a pilot scheme currently being supported by funding from local clinical commissioning groups, Macmillan Cancer Support as well as by St Luke’s own fundraising initiatives.
Following the initial success of OneRespose, the hospice hopes that it will be possible to broaden the model by working collaboratively with colleagues at Saint Francis Hospice and the J’s Hospice.
Helping patients to remain in their preferred place of care
OneResponse nurse co-ordinators Tammy Murer and Stuart Cross explain how the service helped one patient remain at home:
“We received a call in the early hours of the morning from a family member of a patient who was concerned that her husband’s symptoms had suddenly started to change. The patient, who was already being treated for advanced cancer, was in distress and pain.
“Assessing information received during the call it was decided that a ‘rapid response visit’ needed to be made. The team which visited included a OneResponse qualified nurse and a Marie Curie senior healthcare assistant.
“During the visit and further assessment, the OneResponse nurse was able to have a telephone consultation with the patient’s out of hours GP to agree authorisation for medication that was required immediately. The nurse then travelled to meet with the GP, collected the authorisation and returned to the patient to administer the pain relief.
“During this time, and until the medication took effect, the Marie Curie senior healthcare assistant remained with the patient.”
The following day Stuart contacted the patient’s hospital team and specialists to ensure that the patient received appropriate follow-up, and also notified the wider team who were involved in caring and supporting the patient – this included the patient’s own GP, district nurses and Macmillan teams.
Stuart explains that without the team’s input “the situation would have escalated to a greater crisis and resulted in the patient being taken to hospital unnecessarily.”
Adding: “More importantly we had been able to meet the patient’s preferred place of care at home, which was primarily my reason for joining OneResponse – this is the difference I was hoping to be able to make to patients by changing jobs.”
Tammy adds: “’Since I have been working for OneResponse I feel that the ethos and unified approach across all the teams truly places the patient at the forefront of what we do- striving for a more structured framework of care and support. I firmly believe that OneResponse has and will continue to improve the delivery and access of care to people with palliative and end of life care needs.”