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Dying at home the Midhurst way.

Catherine Waight1, Bill Noble2

  • 1Cornwall Hospice Care, St Austell, UK.

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|May 18, 2019
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Summary

A consultant-led community palliative care team provides high-quality end-of-life care at home, achieving 85% preferred place of death. This model enhances primary and secondary care collaboration, reducing NHS costs by 20%.

Area of Science:

  • Palliative Care
  • Community Health Services
  • Healthcare Management

Background:

  • High-quality end-of-life care is a significant challenge for UK primary and specialist palliative care services.
  • A specialist palliative care inpatient unit in Midhurst closed, necessitating alternative care models.
  • There is a need to extend specialist palliative care support into community settings.

Purpose of the Study:

  • To establish a consultant-led community palliative care team to deliver specialist care in patients' homes, care homes, and community hospitals.
  • To integrate community palliative care services with primary and secondary care.
  • To evaluate the effectiveness and cost-efficiency of the community palliative care model.

Main Methods:

  • Implementation of a consultant-led community palliative care team.
Keywords:
PROCESS AND SYSTEMS

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  • Collaboration with primary care to enhance community services.
  • Facilitation of rapid hospital discharge to the community.
  • Integration of anticipatory prescribing and advanced care planning.
  • Education programs for social care and nursing home staff.

    • Main Results:

    • The Macmillan Midhurst Service costs an average of less than £3,000 per patient.
    • 85% of referred patients die in their preferred place of care.
    • Evaluations show benefits for patients and families.
    • Early referral leads to approximately 20% cost reductions for the NHS.

    Conclusions:

    • A consultant-led community palliative care team can successfully provide high-quality end-of-life care outside of inpatient settings.
    • This model effectively supports patients' preferred place of death and enhances integration between different healthcare sectors.
    • The service demonstrates significant cost savings for the NHS, particularly with early patient referral.