bluuebunny/crossref_metadata_2025_split huggingface dataset:
P89 You don’t get a second chance to make a first impression…
Authors: Finnerty Jane , Haywood Chris , Ellis John , Turnbull Ian , Jones Debbie , Bennett Pat 
Published: October 2013

Background/contextFostering good first impressions of a care setting are an important component of building confidence and providing reassurance for patient’s, carers, relatives and visitors. The 15 Steps Challenge is a toolkit devised by the NHS Institute for Innovation and Improvement in 2012 to help staff, patients and others to identify improvements that enhance the patient experience and environment. Initially15 Stepswas developed for use in Hospital wards but we adapted it for the whole Hospice environment.AimsTo use an accredited quality improvement tool and clear framework to facilitate in depth observations of quality care across four domains:WelcomingSafeCaring and InvolvementWell organised and calmApproach usedReadily available easy to use literature to guide implementationPowerPoint slides for awareness sessions and trainingSmall team to undertake the review (included 1 patient/carer representative, 1 non-clinical staff and 2 clinical staff)Dedicated toolkitEngagement with internal stakeholdersA structured walk around the entirety of the Hospice environmentPresentations to different staff groups on findingsFocus on positive feedback and sharing good practiceRepeated at 6 months to show achievements and improvementsOutcomesExplicit patient/carer perspectives were taken into account.Detailed action plans with key positive impacts on the working environment.Supports the Care Quality Commission’s Essential StandardsCase study for evaluation (IES) by telephone survey.Application to Hospice PracticeUse of the 15 Steps toolkit clearly effective as a quality improvement initiativeRe-audit has shown improvements in all domainsHeightened staff awareness; quality is everyone’s businessStrengthened communication across servicesAdaptable for use in Fundraising/Trading Company improving quality across the organisation.The Challenge can be repeated on a regular basis to cover all areas and to ensure that improvements are being progressed and maintained.
P90 Delivering an integrated end of life care service for greenwich – the benefits and learning two years on
Authors: Heaps Kate 
Published: October 2013

BackgroundThe Greenwich Care Partnership (GCP) was born out of the Marie Curie Delivering Choice Programme (DCP). Three service providers were asked to develop the service, the Hospice acts as the prime contractor and sub-contracts others to deliver specific elements of the service.AimThe service aims to increase the number of people who die in their place of choice by ensuring that appropriate health and personal care services are available and that their families have sufficient support.Approach usedThe service operates alongside core services to support high quality care across four areas:Care co-ordinationRapid Response ServicePersonal care and supportNight careAlthough the elements of service are provided by different providers, they work together to ensure care is seamless 24/7.OutcomesThe GCP was commissioned as a “test and learn project”; now in it’s 3rdyear, the service has developed in response to local need and resources have been flexibly allocated to provide responsive, high quality care.Each provider has signed up to the success of the project and each has an equal stake in ensuring that the service meets its key performance indicators.The project has succeeded in supporting an increase in home and hospice deaths and a reduction in hospital admissions, length of stay and deaths.Application to hospice practiceThe model and contracting arrangements have attracted National interest amongst Hospices and commissioners, and has been cited as a model of good practice for others to build on.Thinking strategically about the role of hospicesThe GCP model is a natural extension of the Hospice service, producing efficiencies and quality improvements. With the current proposed model for palliative care funding, Hospices will need to take on the role as prime contractors in order to survive.
P91 Partnerships: A public health interpretation of living well and dying well
Authors: Zammit Rachel , Horton Siobhan , Atkin-Ward Julie 
Published: October 2013

AimThe overarching aims of the Cheshire Living Well, Dying Well Programme are to improve health and well-being by supporting a change in public knowledge, attitude and behaviour towards death, dying and loss and therefore make living well and dying well the norm.BackgroundSt. Luke’s Cheshire Hospice engaged in a community consultation process which highlighted that local partner organisations supported a co-ordinated public health approach to raise awareness and change behaviours in relation to death and loss. St. Luke’s secured funding and a commitment of engagement from Macmillan Cancer Support, which included establishing a dedicated role to centrally lead and drive forward the agenda in Cheshire.MethodologyAs death, dying and loss is a cross-cutting issue, it is important that a multi-faceted approach is developed and delivered in partnership. It is also important that the work is championed and embedded at strategic, operational and community level. The programme of work provides structure and support to enable partners to work together towards achieving the shared aim.Findings and RecommendationsFollowing consultation, six strategic areas have been identified; Partnership and Strategy Development, Financial Housekeeping and Future Planning, Resource Development, Public Education, Compassionate Communities and Healthy Workplace.The work is also being championed at Health and Well-being Board Level.Highlights include:The formal launch and implementation of Cheshire Living Well, Dying Well PartnershipIdentification of Cheshire Living Well, Dying Well ChampionsDevelopment and implementation of a range of resources (including support and training sessions for the public, staff and volunteers)Development and implementation of Compassionate Community Volunteer ModelsPresentation of the Programme at a local, regional, national and international levelConclusionImproving the well-being of communities by normalising death and loss is a multi-agency issue and not singularly confined to those in the health arena.This innovative approach identifies and enables partnership activity and the collation of evidence to progress further, with a view to mainstreaming the work.
P92 Isabel hospice benefits advisor partnership
Authors: Ford Lesley , Dodd Helen 
Published: October 2013

Is a bel Be nefits Advisor and East Herts Citizens Advice Ser vice Partnership and supported by the Big Lottery Fund.The partnership between the Isabel Hospice and East Herts Citizens Advice Service (EHCAS) was formed in 2010 to enhance the services for patients assessed as requiring support for financial, legal matters, employment, utilities, debt, housing, immigration and nationality, taxation and discrimination as well as relationship advice to ensure that the most up to date information is made available.Evidence has shown that people living with life limiting illness such as cancer do not receive benefits and other forms of support for which they are eligible. The complexities of the welfare system can seem overwhelming at a time when they are struggling to come to terms with their situation. Isabel Hospice is the service provider for Specialist Palliative Care in Eastern Hertfordshire that has a population of around 358, 000.From October 2010 to June 2012 the Isabel Hospice Clinical Nurse Specialists provided benefits assistance to more than 1,700 clients. The Benefits Advisor was then able to offer more specialist advice to 400 clients.It is imperative that the Benefits Advisor role is kept fully up to date with welfare reform and able to ensure that the Clinical Nurse Specialists are kept updated with changes.It is estimated that the annual amount awarded to those under the care of Isabel Hospice as a result of the Partnership was in excess of £368,000. The top five benefits in which assistance has been given were for Disability Living Allowance, Carers Allowance, Bereavement Support and funeral payments, council tax benefit and employment allowance.The Partnership has enabled the East Herts Citizens Advice Service to reach clients that it would not have been able to before. At such a stressful time it can be difficult to fit in a further appointment or even travel to the EHCAS - working collaboratively has enabled more patients and carers to receive the appropriate services to enhance the challenges faced when living with Life Limiting Illness either in the home, Day Services or our In- patient Unit.
P93 The hospice of St Francis spring centre: collaboratively reaching more people
Authors: McLaughlin Kimberley , Traxler Polly , Valentine Wendy 
Published: October 2013

Context“Hospices will need to change is beyond doubt. The scale of the challenge ahead is dramatic and will require hospices to significantly increase the extent and scope of end of life services”(Calanzaniet al2013). Since 2007, cancer diagnoses have increased by 16% in Hertfordshire and over the next 10 years projected to rise a further 14%. This collaborative project with our neighbouring hospice provides a locality-wide community programme to support those recently diagnosed or living with serious illness, their families, carers, friends and the community. Over the next 3 years, The Spring Centre will reach over 1,000 more patients and their families.ApproachRe-aligning existing resources and community engagement is key to our programme. The St Francis Choir, Coffee Mornings and Film Club engage our community in regular activities throughout the year. Medical, nursing and therapists clinics provide physical, emotional and psychological support. Focused groups by our rehabilitation team range from fatigue management workshops, breathlessness groups, complementary therapy, gardening and creative therapies. Our Carers programme offers individualised support including benefits advice and relaxation classes. A variety of groups for bereaved adults, children and young people invite opportunities to share experiences, enjoy our gardens and even cooking classes! Outcome measures used to identify the effectiveness of attending the pilot fatigue group in 2012 showed that 80% of people felt they had the skills and energy levels to participate in more social or work activities.Feedback also highlights benefits, ‘the carers’ support group is a lifeline to me’.ConclusionThe Spring Centre at The Hospice of St Francis is an example of thinking strategically and collaboratively about the role of our hospice, re-aligning existing resources and delivering the care that people want and need.
P94 Developing a Motor Neurone Disease (MND) service in austere times: the power of partnership working
Authors: Coupland Karen 
Published: October 2013

BackgroundPrior to the changes, pockets of good practice existed but services were uncoordinated and communication ineffective. Care was often reactive in response to crises and patients reported feeling unsupported and uncertain whom to contact should their condition change. A multi-disciplinary MND clinic existed; however this was hospital based, difficult to access and community service provision was patchy. The need to improve services was identified at a stakeholder event, which brought more than 60 people with MND, carers, professionals and commissioners together.The post of MND Coordinator was developed in discussion with the local MND Association, and supported by the local NHS Primary Care Trust. The post was funded and based within our local hospice in Bedfordshire, with the aim to take the lead and establish a single point of contact from diagnosis to death, for people with MND.Clinical outcomesTimely referrals to agencies for equipment, adaptations, therapy, information and supportMDT clinic moved, making this more accessible, as well as promoting sensitive introduction of hospice and palliative care services – improving access and advanced care planningDomiciliary visits offered for support, monitoring and hospital avoidanceDischarge planning from hospital/hospice to reduce length of stayLocal organisations working together, promotes psychological and emotional wellbeing for people with MND and their carers and encourages self-managementHealth and social care professionals benefited from MND specific education delivered collaboratively by statutory and charitable servicesComments received‘The clinic is in such a lovely setting and much better for patients to attend than hospital’‘It is a hugely important role. Having someone there to monitor the health and wellbeing of people, who otherwise can fall down a hole.’RecommendationsIdentify opportunities for collaborative working with local champions, using the voice of people living with MND and their carers to identify poor quality services and drive up standards.
P95 Above and beyond - the power of international partnerships
Authors: North Kate , Marston Joan , Thambo Lameck , Tauzie Jean , Paleri Anil , Talawadeka Pradnya , Muckaden Maryann , Chipulta Fred 
Published: October 2013

IntroductionThis project brings together partners from India, South Africa, Malawi and the UK to expand children’s palliative care services in Maharashtra state in India and in Malawi.The project results have prompted commitment to palliative care service development above and beyond the original project scope. It demonstrates how international partnerships can inspire and promote others to take on palliative care to meet the huge need for palliative care around the world.MethodsThe project uses international donor funds to integrate children’s palliative care into existing services in both urban and rural settings.Each partner brings to the project distinct skills and experience; ranging from project and donor management, paediatric palliative care knowledge, training and mentorship expertise, and advocacy skills.ResultsThe mix of these skills has seen the following key results:The development of children’s palliative care services in 5 new settings.The integration of children’s palliative care into health service curricula.The inclusion of children’s palliative care in draft palliative care policy.The project has also prompted extended impact:The National Rural Health Mission (Jawhar, India) has committed to a wider programme of palliative care service delivery and is already funding training, staff and services.District hospitals in Malawi are showing strong interest in developing palliative care servicesProject stakeholders are increasingly seeking extra funding and gifts in kind to support and develop children’s palliative care services.DiscussionThe collaborative implementation of this project has proved to be a catalyst for further development of palliative care than originally anticipated.We would like to share our collaborative approach, together with more detailed results to inspire and encourage others to engage in partnerships to maximise impact and rise to the great challenge of meeting the huge need for palliative care internationally.
P96 A survey for children/young people supported by a hospice
Authors: Stanford Jo , Phillips Ruth 
Published: October 2013

A survey for children/young people supported by a hospiceIntroductionThe Care Quality Commission requires agencies to enable services users to participate in the development of the service.AimsThis survey represents a children’s hospice first attempt to hear directly from the children and young people they support as part of the organisations Clinical Governance process.MethodsChildren and young people using hospice services have a wide range of needs, abilities and disabilities. Participants were encouraged to complete the surveys on their own if able or if needed with help from their siblings or parents/carers. The format was a simple questionnaire provided on paper and accessible on-line to offer participants a choice about how to reply.Completed paper surveys were added to the on-line programme manually by the Clinical Governance Facilitators to aid collation and analysis.ResultsOf the 438 forms sent out 67 (15%) were retuned; some completed by the child/young person, on their behalf by siblings or parent/carer or siblings from their own perspective.Respondents commented on activities they would like to see offered by the hospice such as DJ evenings and outings including holidays abroad. They also highlighted a few things they didn’t like such as staying over at the same time as young children.DiscussionThe survey offered children and young people with a range of complex needs the opportunity to comment on their experiences. The results will be shared with staff so they can discuss and consider ways of implementing changes to their practice in an effort to meet specific needs and improve the experiences of the service users.ConclusionThe survey has provided a starting point. In future we plan to review the survey and include other methods such as participant observation to offer more children and young people the chance to participate.
P97 Development of the advanced nurse practitioner role in hospice care: A medical model
Authors: Hookey Claire , Whelan Jane 
Published: October 2013

Background/ContextThe role of the Advanced Nurse Practitioner (ANP) encompasses the provision of advanced levels of clinical practice, knowledge and skills. Whilst involving aspects of education and research, it is firmly grounded in direct clinical care. Responsibilities include assessing, diagnosing, planning and implementing programs of evidence based care and treatment. The drive to reduce junior doctors’ hours in hospitals in the last decade led to further development in the ANP role, with increasing autonomy and application of expertise ( RCN 2012). More recently, the ANP role has translated into hospice care, although generally these roles have developed within hospice nursing teams.AimFollowing the resignation of a Speciality Doctor it was decided to develop an innovative ANP role within an already established, experienced medical team.Approach usedAn ANP role was defined for our local context with reference to national guidance and recommendations from the Royal College of Nursing. The role sits within the medical team, and involves the assessment and management of hospice patients, working autonomously but with support from the medical team. The ANP also participates in the medical on call rota, supported by the Consultant on call. The successful candidate had many years of nursing experience both in hospital and community, working at an advanced level within nursing.OutcomesThe ANP role challenges traditional professional boundaries. However, the ANP has integrated well into the medical team, and both medical and nursing staff have identified benefits from the skills and experience that the role has brought. The post has also provided a cost effective means of fulfilling many roles normally undertaken by a doctor.Application to hospice practiceOther hospices may wish to explore the development of Advanced Nurse Practitioner roles within their own medical teams.
012 Improving the transition process for young people with life-limiting conditions
Authors: Sivell Stephanie , Lidstone Victoria , Taubert Mark , Thompson Catherine , Nelson Annmarie 
Published: October 2013

Research AimsTo identify the training needs of adult Specialist Palliative Care (SPC) teams to care for young adults and inform the development of an education package for adult SPC teams.BackgroundThe prognosis of life-limiting conditions of childhood has improved with an increase in the number of young people accessing adult SPC services. Adult SPC teams may be inexperienced in caring for the complex needs of these young people.MethodsDelphi: An online Delphi process collated expert opinion on format, delivery and content of the educational package in three rounds.Focus Groups: Focus groups were held with young people with life-limiting conditions, staff from a local adult hospice and carers. Discussions explored the care and support needs of young people and their families, and the training needs of SPC teams. Data were analysed using thematic analysis.ResultsDelphi: Consensus was reached on range suggested formats and personnel to deliver the training, and on clinical, psychosocial and practical topics. Training should be delivered as a continuous/rolling programme and not as ‘a one-off’.Focus Groups: Discussions centred on: challenges of caring for young people; barriers to transition; staff education and training; facilitating transition.ConclusionsThe knowledge required by adult SPC teams to meet the complex needs of young people and their families is diverse and extensive. To optimise learning, training should be delivered as a continuous/rolling programme, tailored for content and mode of delivery. A template to guide handover and a single point of contact would facilitate the transition process.Application to Hospice PracticeA series of study days has been designed using the information gathered in this research and will commence in June 2013. A template to guide handover is in development with plans to create a single point of contact to co-ordinate the transition process.
P98 Developing an advanced nurse practitioner role in hospice care: A workforce transformation project
Authors: Starnes Gina , Marciano Sally-Ann , Sowton Clodagh , Burt Andy , McDonough Elaine , Twomey Colin , Larden Michelle , Taylor Karen 
Published: October 2013

Twelve hospices from the ECLIHP Regional group working with Skills for Health as part of a successful bid for £10,000 foa a supported project.The overall aim of this project will be to improve the quality of care for people with complex palliative and end of life care needs and their families by ensuring 24/7 direct admissions access to specialist inpatient hospice beds and emergency out of hours assessment in the community.The intention of this project is to support delivery of a flexible and responsive 24/7 hospice admission and assessment service through redesign of the existing workforce to introduce an Advanced Nurse Practitioner (ANP) role within the team.Impact will be measured by agreed Key Performance IndicatorsDesired Outcomea Transferable Role Template for the ANP in Hospice Care defining the skills, competence, learning and development needed to fulfil this role.an outline Business Case Template to build the case to commissioners of the benefits of the ANP role in improving the quality of care for people with complex palliative and end of life care needs and their families by ensuring 24/7 direct admissions access to specialist inpatient hospice beds and emergency out of hours assessment in the community.Deliverables:Development of an ANP Transferable Role Template within Hospice Care to be included in the Skills for Health Learning Bank.Development of a Education and Training Framework to underpin the role.An outline Business Case Template targeted at CommissionersWritten Job Description for the ANP Role in Hospice Care.How to achieve the deliverables?Define role, responsibilities and core job descriptionCreate a Clinical Reference Group and arrange workshopsDevelop formal partnership arrangement to support the projectIdentify evaluation processAgree scope of role and map competences/skills (NOS) sign offAgree core education programmeConduct baseline evaluationComplete clinical/technical skills training and competency sign offDefine role, responsibilities in preparing Business Case TemplateAgree Business Case and Sign offProduce project outcome report