bluuebunny/crossref_metadata_2025_split huggingface dataset:
P19 Widening access to hospice services: The development of a 7/7 community specialist palliative care nurse service and a rapid response service pilot
Authors: Saunby Deborah 
Published: October 2013

Background and ContextIn response to national Peer Review Standards and NICE Guidance to offer 7 day face to face visiting an opportunity to pilot a service within a hospice based Community Specialist Palliative Care Nursing Team arose. Within this the development in order to be more responsive a Rapid Response service has been developed.AimTo widen access for patients with specialist palliative care needs to holistic assessment by a Clinical Nurse Specialist and offer greater flexibility in options for home assessments. To offer an urgent response based on clinical need 7 days a week, for crisis intervention. To assess need for urgent admission to an inpatient unit bed or facilitate the patient remaining in their own home if desired.Approach UsedA review of caseload configuration across the city with the development of 4 zone teams. A significant investment in resources to support an additional 3 WTE Band 6 Associate Community Specialist Palliative Care Nurses was agreed for a temporary period of 6 months, with successful recruitment to the posts.All referrals to the hospice service are reviewed through a multi professional meeting and triaged according to urgency and priority, with the capacity for immediate home assessment, 7 days a week and greater flexibility for managing routine and follow up reviews.OutcomesMeasures will be determined through review and analysis of all Rapid Response visits to determine whether patient preference over place of care has been met.External stakeholders opinion regarding perceived satisfaction with 7/7 access and rapid response in the management of community patients.Cost- benefit analysis of investment of resources on improved caseload management to inform strategic service development.
P20 The Sikh population of North West Kent: exploring the lived experience of caring for a dying relative at home
Authors: Cowan Margaret Mary , Withell Bridget 
Published: October 2013

Research AimsTo explore the Sikh population’s experience of caring for a dying relative at home and develop an understanding of their experiences.Background /literature reviewHill & Penso, (1995) reported under-use of specialist palliative care services by minority ethnic groups with minimal improvement noted in present day (Gunaratnam, 2007, DoH, 2008). Often, end-of-life needs are unfulfilled ( Worthet al, 2009, DoH, 2010, DoH, 2011). Locally, Sikhs account for 12.8% of the population although only 1% of referrals to local hospice are Sikh.MethodA qualitative study, facilitating interviews in Punjabi and English, using interpretative phenomenological analysis to analyse the transcribed data.Results/DiscussionFive super-ordinate themes identified:Factors leading to the caring role;Emotional effects of caring on the carerImpact of caring on the wider familyInfluence of the health care servicesReligious and cultural influenceLack of support from health care professionals emerged as an overriding theme An overwhelming sense of duty pervaded each family sustaining them to cope. The option of their relative being nursed in care home/hospice was unlikely as participants reported fears that care could only be received if it was paid for. Culture and religion played an important role in the caring role.ConclusionsGPs and hospices need to take a major role in identifying patients with non-malignant disease to ensure referral to other services. Access to equipment is uncoordinated. Financial concerns over care are apparent in this population. Sikh carers need to be educated and supported to continue to support their relatives.Applications to hospice practiceAllows equity of care to patients dying of non-malignant disease. Improves bereavement support for this population. Engagement with community may need to extend to outreach clinics to raise awarenss within this population. Extends education on end-of-life issues to this minority ethnic group.
P21 Comforting touch at home
Authors: Williams Sue , Birch Helen , McDonald Bernadette 
Published: October 2013

AimsHospice at Home service works with other community services to fill gaps in end of life care for patients, whose preferred place of care is home. A twenty four hour / seven days a week sitting service is delivered predominantly by trained Healthcare Assistants (Aides), who recognised that anxiety and breathlessness might benefit from immediate, simple non pharmacological interventions.MethodsSimilar interventions are provided by appointment at the hospice and the Hospice at Home team were trained in simple skills and techniques (basic hand and foot massage, the importance of touch, and anxiety and breathlessness management). Regardless of the severity of condition, touch can always be safely administered and studies show massage as the second most commonly administered non-drug strategy to reduce symptoms. Hospice at Home Aides were encouraged to use these skills and techniques with patients, and teach them to families and informal carers where appropriate.ResultsWe present audit and survey results of this positive partnership between hospice, Aides, complementary therapists, families and community services.ConclusionFamilies described better outcomes, empowered by doing something practical instead of feeling inadequate and helpless. Patients’ symptoms were relieved immediately in the home instead of waiting to attend the Hospice, and confidence levels and job satisfaction increased amongst the Hospice at Home staff because they could respond immediately by providing a non-pharmacological technique for these distressing symptoms in the patient’s place of choice - home. A cost effective, one stop shop!
P22 Patients Help To Shape New Day Hospice Programme
Authors: Birch Kathy 
Published: October 2013

Background/Context of the workPrincess Alice Hospice had a thriving therapeutic but traditional model of Day Hospice. Staff identified, however, that some patients declined attendance or stopped attending after a short time. Feedback indicated this was due to the inflexible nature of the model.Aim and approach usedA period of consultation was planned, with main stakeholders, to explore opinion and different models of care. Meetings were held with patients, staff, referrers, Trustees, hospitality and driving volunteers. A questionnaire was subsequently developed and sent to these stakeholders to provide further data. One hundred and fourteen questionnaires were returned and analysis of data provided evidence to support change while retaining some of the traditional model of care.OutcomesA redesign of the weekly programme to include three days of the traditional Day Hospice model and two days of new individual and group activities.Increased flexibility in the servicePatients accessing different elements of the service at different stages of their journeyFull day, half day and one hour appointmentsAdditional carer support activities.Opportunities for staff and volunteer development.Ongoing re-evaluation of the programme and adaptations as needed.A service which is now more receptive and open to change.Application to hospice practiceHospice services are being challenged to consider their future and plan strategically to meet the changing needs of the people they support1. Day services should not be exempt from this scrutiny. Changing a model of care can be difficult and painful, but services must ultimately meet the needs of the people they support to be viable. In a changing social and medical world Day Hospice services need to be flexible and open to change in order to deliver and sustain a future proofed service.Reference1Calanzani et al (2013)Current and future needs for hospice care.Help the Hospices, London.
P23 New model of day therapy services within Lincolnshire - opening doors
Authors: Mumby Mark , Jones Rachel 
Published: October 2013

Historically the predominant case mix for Day Care was elderly patients, those in their last year of life and with primarily a cancer diagnosis.In 2011 we reviewed how services could be provided countywide for a rural county population circa 712,000 (1) that would assist patients earlier in their palliative journey, those with non cancer diagnosis and attract younger patients. We aimed to increase the capacity to support more patients within existing resources and deliver a wider range of therapeutic interventions.To achieve accessibility for the maximum number of patients, services were established in eight different locations including providing therapy within GP practices and community halls, and also inreaching to meet the needs of dementia patients in a nursing home setting.Whilst the philosophy was unchanged, the service was redesigned and continues to develop responsively and with flexibility. A diverse range of therapeutic interventions are available and a plan of care is tailored to meet the individual patient and carer needs following assessment. New volunteer roles with specific profiles were developed to augment the nursing staff. The community engagement officer increases awareness to diverse and often hard to reach groups.Evidence from patient reported outcome measures, piloting and evaluation enable creative and on going service design to meet emerging needs. Structured training programmes for staff and volunteers continue.Increased access to the service is evidenced by data collection, demonstrating a 51% increase countywide, with 70% increase of 18-64 age group and 74% increase in non cancer patients, demonstrating greater opportunities for those with life limiting illnesses to be supported to reach their full potential.This service will be sustained and enhanced by working in partnership, signposting, and through additional innovation such as commissioned Carers Assessment.Lincolnshire Research Observatory.http://www.research-lincs.org.uk/Latest-Population.aspx
P24 TESSERA and beyond
Authors: Smith Jannette , O’Neill Julia 
Published: October 2013

For the past 10 years, Pendleside have made one of their Day Therapy days available to non palliative patients. The day referred to as Early Diagnosis Day (EDD) was essentially aimed at patients with a recent cancer diagnosis being treated with curative intent.Whilst the EDD was innovative and popular initially, more lately it had become stagnated and predicable. It was also recognised that it was not fully in line with the work being done locally and nationally which has “survivorship” as a key element.Patients were consulted and responded enthusiastically to the ideas suggested for service improvement. Indeed the TESSERA name was chosen by a patient group.It is acknowledged that a cancer diagnosis can be shattering and life changing. With appropriate support patients can and do rebuild their lives. It was on this basis that the name was chosen. A Tessera is an individual tile used in creating a mosaic. Which was thought to be an ideal representation of rebuilding in the finest form.TESSERA:Together, Experience, Solace, Survivorship, Empowerment, Rehabilitation, Adapt.TESSERA offers an eight week rolling programme of activities, presentations and interactive workshops delivered by outside agencies in addition to Hospice and Trust staff. This is further complemented by peer and healthcare support including an extended MDT.The day runs from 10am – 3pm.Sessions are offered using a menu ‘pick and mix’ system. Attendance can be one session or a full day (and anything in between). Graduated arrival enables higher patient flow.Exercise classes, Tai Chi, Emotional Wellbeing and Fatigue Management groups are timetabled as fixed sessions. These all contribute to the ultimate aim of empowering patients to regain a lifestyle that is enriched both emotionally and physically.
P25 Transforming day care services across boundaries
Authors: Linehan Gaberielle , Snow Caroline 
Published: October 2013

South of England Hospice, population of 370,000-380.000, 14 inpatient beds and community team supporting approximately 300 patients.Day care services previously delivered via a care model unchanged in twenty years; all day attendance with no defined focus.A service review in 2011 demonstrated that on average 33 patients attended over four days from a community case load of approximately 300 (cost £4545.45 per patient). Referrals from the CNS team took on average two to three weeks to be processed to arrange a ‘look around’. Following this 40% of patients were unable to attend due to condition deterioration. A CNS caseload review demonstrated the patient demographic was changing to younger more discerning patients wanting specific treatments for attendance.Day care services were suspended in May 2012 for a refurbishment project. This allowed a rethink on the parameters of the service, aiming to focus, energise and engage.Service reopened in October 2012 delivering morning or afternoon sessions each with a specific focus. Lead for day care changed to a therapist with nurse support. Activities include, Hope course, art and craft, yoga, music therapy, bathing service on one afternoon, complimentary therapies, lunch clubs and an information centre once a month for all patients /relatives.Focus of engagement changed from CNS referral to direct patient contact with a choice in activities. Attendance: STEP 1- three months accessing two sessions weekly plus a lunch club: then STEP 2- choice of one activity monthly and a lunch club. Eliminates need for discharge and allows for ongoing monitoring and engagement with hospice.In the six months to March 2013 there has been engagement with 89 patients’, representing an increase of 166.8% over the 6 month period reducing the cost per patient to £1685.39.User feedback is positive and active ongoing service review and development is planned.
P26 ESV is just the start
Authors: Filsell Karen , Levy Gillian 
Published: October 2013

IntroductionThe organisation has been involved for some time with Employer Supported Volunteering. In recent years we have seen a significant increase in the number of requests for Employer Supported Volunteering projects. At the same time, the fundraising team was tasked with further developing corporate relationships.AimsThe aims were to:develop a more professional response,develop creative and interesting opportunitiesuse ESV as a springboard for further engagement with companies.MethodsThe Voluntary Services and Corporate Relationships teams developed an approach which included clear policy and procedures and a project bank across the organisation. All enquires are channelled through the Corporate Relationships team, and visits to companies are made before and after each activity to manage expectations and develop the relationship further.Activities in the hospices include gardening, wrapping Christmas presents, and putting up or taking down Christmas decorations. Whilst in retail ESV volunteers became involved in window dressing challenges, as secret shoppers, or taking part in sorting challenges which are also involve the collection of donated goods from the participating company.The Fundraising team also seek support from companies with bucket shakes, bag packs, and marshalling at large events.OutcomesOutcomes from the project include:Completion of much needed organisational projects, eg development of play areas, sorting of stock for retailStronger, more productive partnerships with companiesLong term relationships - companies want to come backIndividuals becoming regular volunteersConclusionThe organisation is committed to further investment in this work and acknowledges that developing these relationships takes time and energy. The organisation has benefited greatly from creative and engaging projects that have provided benefit to children, young people and families and have helped develop strong corporate partnerships through volunteering.
P27 Volunteer hosts
Authors: Clarke Karen 
Published: October 2013

BackgroundAutumn 2013 the hospice relocates to its new 20-bedded facility. To offer a more worthwhile and less segregated volunteering experience, a generic volunteer role was created to replace Ward Helpers, Receptionists and Day Therapy Helpers.AimOffer a positive, friendly greeting to visitors via a well-informed, approachable “Host”Create a volunteer ‘workforce’ aligned to the vision of the hospice as a community resourceDevelop a flexible team able to respond to changing demandsProvide peer support and integration.ApproachConsultation meetings: (i) volunteers affected and (ii) wider volunteer community. Meeting 1: Design and vision for the new building; Meeting 2: Potential role changes and consultation; Meeting 3: New roles and invitation to express interest.Consultation with a volunteer focus group resulting in:creation of volunteer Host Liaison role (to oversee the volunteer Hosts on duty)weekly rotation of HostsHost ‘uniform’.Visits to the new hospice.Outcomes77 existing volunteers have applied and been offered Host roles49 unsolicited external applications received.Feedback:“I now feel very excited and privileged to be part of the beginning of the new life of the Hospice.”the“meeting did a good job of clarifying what’s proposed and is another step towards the new set-up.... All feeling very positive”“... having walked around the new build today, and with your input as to how life will probably be I cannot think of anything better to offer our town and neighbourhood”.Application“Volunteers: Vital to the future of Hospice Care” (2012), states that volunteers are vital to the high quality experience of those who seek help from hospices. The role of volunteer Hosts demonstrates a new approach to volunteering and offers volunteers a rewarding and life enhancing experience.
05 An evaluation of the “Just in Case” bag anticipatory prescribing scheme in Devon 2011-2013
Authors: O’Loghlen Laura , Baines Becky 
Published: October 2013

Background“Just in Case” anticipatory prescribing schemes are seen as one way of ensuring that patients nearing the end of their lives can have access to rapid relief of symptoms at home. The Gold Standards Framework for End of Life care encourages this a mainstay of care. No large scale attempts to examine the practice have been undertaken.AimsTo assess the implementation of “Just in Case” bags in Devon over the first two years of the scheme. Feedback was sought from health professionals over the key features of the initiative, the drugs used and any problems encountered. A subsidiary aim was to assess the cost effectiveness of the scheme.Approach used83 GP practices in Devon were issued with a stock of “Just in Case” bags. A record was kept of when each bag was dispensed. Each bag was issued with a service evaluation form inside. The completed forms were returned to a central collection point allowing the total number of bags dispensed, and then used, to be measured. Data was collected between April 2011 and the end of March 2013.Outcomes1510 bags were dispensed during the period and 295 service evaluation forms were returned (20% return rate). The bags were well received by staff, patients and relatives alike. The most common four drugs prescribed were Diamorphine, Hyoscine Hydrobromide, Midazolam and Levomepromazine.Application to hospice practiceAn attempt was made to calculate the overall cost of the project and any savings from the scheme. The information gathered from the 295 completed evaluation forms suggested that 121 admissions to Hospital or Hospice were prevented. The bags also offered peace of mind for patients and relatives. The challenges of organising a large-scale service evaluation across multiple professional teams and of assessing projected financial savings are also discussed.
P29 Willen hospice - supporting volunteers to support patients and their families
Authors: Whear Sue 
Published: October 2013

TitleSupporting Volunteers to Support Patients and their FamiliesBackgroundPatient and Family Services provide emotional support to patients and their families through Carers Support, Young Peoples Support and Bereavement Support. This is facilitated by volunteers who have been trained in offering skilled support for people who are going through a very difficult time.AimsTo train volunteers to a high standard, equipping them with the skills to support patients, carers, children and young people and those who have been bereaved.Provide regular supervision for volunteers, offering support, guidance and structure.To develop volunteers through 1:1 reviews.Approach UsedVolunteers work in one of the departments three services Patient & Carers, Young People’s or Bereavement Support. They are required to complete a 9 week training programme including:LosesGrief Responses (including age appropriate)The Journey of CancerCommunication, Listening SkillsPre-bereavementAttitudes towards DeathBeginnings, Middles, EndingsBereavementPractical ActivitiesBoundaries, SupervisionPolicies, On with the JobSafeguarding Children & AdultsMonthly supervision takes place with volunteers by way of client caseloads; update on the Hospice and Department and a topical discussion. 1:1 meetings take place annually and are centred on the volunteer, their development, guiding them to use their skills appropriately.OutcomesPatients and their families are supported by skilled, committed volunteers, giving them the opportunity to talk about their emotions, in a safe, confidential setting helping them find their coping strategies.Volunteers are valued, nurtured and respected for the work they do.Application to Hospice PracticePatient and Family Services combines support and activities through volunteers for patients and their families delivering innovative methods of support and services which encompasses the Hub model, bringing it to the centre of the community.
P30 Recognised, valued and supported? A carers befriending service is an innovative way of developing the use of volunteers, improving quality outcomes in end of life care
Authors: Scott Cheryl , Sutcliffe Olwen , Seed Jessica 
Published: October 2013

IntroductionThe Carers Befriending Service (CBS) is a free service developed by Hospice Social Workers, influenced by the Carers Strategy (2010) and Improving Supportive and Palliative Care for Adults with Cancer (2004).AimsIt provides an inclusive equitable service, supporting carers of people with a palliative diagnosis over 18 years who are mainly housebound and socially isolated. They have to be known to the Specialist Palliative Care Team, have an unpaid carer who provides substantial emotional/physical care on a regular basis.Enables the carer to take a break from their caring role.Assist’s to reduce carer stress.Additional companionship and support to the cared for person.Information to the carer and cared for person.Reassurance to the carer in the knowledge that a trained volunteer is with the cared for person in their absence.MethodsConsultation with service users and carers about the development of a CBS.Literature review undertaken and visiting/researching other end of life care CBS’s.Assessment documents developed.Fifteen volunteers trained and 10 recruited.Outcomes measured by a review process using a solution focused method.ResultsSeptember 2011 – December 2012, 38 referrals, Befriended 17.Aims have been met and carers took breaks by utilising the befriending service for varied reasons. Visits provide up to 4hrs a week, with 2hrs sessions being the most popular.Befrienders provide emotional support and act as a link with the Hospice, improving vital communication processes at the end of life.Service users satisfaction outcomes ‘excellent’.ConclusionCarers Befriending offers a best practice service enabling carers to take a break. A unique emotional relationship is developed with the befriender, improving quality of life and general well-being.Research supports volunteers can make an important contribution to end-of-life care and it meets the requirements of the Government’s ‘Big Society’ principles.