A first for British end of life care practices, the EnComPaSS (Enhanced Community Palliative Support Services) project follows a pilot scheme by Canadian company Sensory Technologies which demonstrated a new way of providing effective and cost efficient care for patients and their families in their own homes.
When the scheme was launched in Canada it saw a reduction in palliative hospital admissions of more than 98 per cent, with Chronic Obstructive Pulmonary Disease/Congestive Heart Failure readmit reductions of 25 per cent and an increase of more than 25 per cent on average of the number of people receiving care.
With the academic support of the National Institute for Health Research, Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR, CLAHRC and YH) the Telehealth and Care Technologies Theme (TaCT) worked with Sensory Technologies to implement and evaluate a proven model for technology at St Luke’s. Junior or band D/band 5 (NHS) nurses were trained and delegated to deliver palliative care plans under online supervision by the St Luke’s specialist palliative care team.
Within two months of implementation in Sheffield, the new system had been fully deployed by all members of the St Luke’s Community Nursing team, allowing for more than 300 patients who are registered at any one time on the system to receive home visits.
Following the successful implementation of the St Luke’s Sheffield project, analysis by the CLAHRC Y&H team, established that the reduction in acute hospital bed use in supporting effective end of life care in this project alone could result in potential savings of £2.4m each year to the NHS in Sheffield.
“Using EnComPaSS, St Luke’s Community Nurses really become the eyes, hands and ears of the Senior Nurse,” said Dr Sam Kyeremateng, St Luke’s Medical Director.
“We believe that this new approach will improve the quality of care for some of Sheffield’s most vulnerable end of life patients, reduce admissions and unnecessary visits to hospital, and help more patients to stay at home.”
Harnessing the latest IT developments, EnComPaSS allows one Senior Nurse or doctor to monitor multiple patients in their own homes from a remote setting, providing direction to St Luke’s Community Nurses who are in the patient’s home, working with the patients and their families.
Using secure tablet computers and software instead of paper-based systems, nurses capture patient clinical data at the patient’s bedside, and can review the data via an online dashboard, thereby improving communication and the quality of shared information across the service.
The development of EnComPaSS has been a partnership between St Luke’s, Western University in Canada, Sensory Technologies of Canada and the University of Sheffield, a partner in the National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care, Yorkshire and Humber
The partnership was awarded £250,000 from the NHS England Nursing Technology Fund to develop the technology and for training required to fully integrate the scheme which has now gone live throughout Sheffield.
Judith Park, St Luke’s Deputy Chief Executive and Director of Patient Care, said:
“The majority of our care is delivered out in the community and at any given time our community nurses have a case load of about 300 patients across the whole of the city.
“This system allows our community team to work closely with day-care services and bring together medical, nursing, healthcare professionals and support teams all working towards one goal, enabling people to die with dignity in familiar surroundings.”