What do we mean by model of care?
There are many, many definitions of what constitutes a ‘model of care’. For our work the aim of the model of care largely is to outline best practice care and services and define the way the future community-based specialist palliative care services are delivered for our NW London population with specialist palliative care needs.
What is the NW London CSPC Model of Care Working Group?
The NW London CSPC Model of Care Working Group has been asked to develop and co-design a new model of care for CSPC. This will be based on best practice and evidence and help us develop high quality community-based specialist palliative care that is delivered equitably and sustainably across NW London.
The new model of care will aim to make sure people have a choice, get the right care, at the right time, by the right team and in the right place, alongside their wishes and preference. All residents no matter their circumstances will be able to access the services they need.
Co-design is the method of involving users (people), stakeholders (decision makers) and practitioners (front line staff) in the process of design. Whenever we are designing new services and patient pathways, it is important that anyone who would like to contribute has the opportunity to input into the process.
Membership of the NW London CSPC Model of Care Working Group, which meets on a weekly basis, consists of local residents, practitioners and other palliative and end of life care stakeholders. Patient/carer members with lived experience contribute and provide feedback on the group’s work, reflecting the voice of patients, carers and their families.
Who are the members of the NW London CSPC Model of Care Working Group?Key palliative and end of life care stakeholders (generalist and specialist) including 12 patient and carer representatives:
We also invite additional topic or other programme related stakeholders when needed. This makes sure the new model of care that is being developed supports integrated care as it is developed with all appropriate interdependent programmes and considers the patient journey through the whole pathway e.g. district nursing. |
The NW London CSPC Model of Care Working Group is being asked to:
- Develop a new model of care that will help us decide what type of services we need and what the common core offer that every patient in NW London should have access to.
- Develop a set of good practice and evidence-based core service standards, requirements and service definitions. These will demonstrate what we believe good community-based specialist palliative care looks like for all our residents.
- Develop a set of co-designed principles that will help us to successfully design and deliver the new patient-centred model of care across NW London.
- Support the development of a long list of options for delivery of the new model of care.
The NW London CPSC Model of Care Working Group have also looked at the future need of the NW London population over the next five years. In particular:
- The future requirements for inpatient bedded services and what they could look like.
- The principles by which we will decide the size and shape of future palliative inpatient services and the number of beds required
- The future requirements for other community-based services (Hospice@Home, Community Specialist Palliative Care Teams, Psychological and Bereavement Support, 24/7 SPC Advice Line, Outpatients, Day Hospice Services).
- The principles by which we will decide the size and shape of these community-based services for the future.
- They have also put forward recommendations as to what supporting services activity (for example, improving uptake of the Urgent Care Plan (UCP) and having a workforce recruitment and retention plan) are needed to deliver good community-based specialist care services and the mechanisms for developing these programme enablers.
The model of care is being designed to support local flexibility and equity of access. This means that the local Borough Based Partnerships will have the ability to develop additional services beyond the NW London core service offer if they wish to, based on their local priorities and local population needs.
The NW London CSPC Model of Care Working Group has met weekly for over three months and we thank them for their hard work and determination in helping us deliver excellent community-based specialist palliative care services for NW London residents. During the meetings they have been provided with detailed background evidence and information and have discussed what good community-based specialist care services should look like and what future capacity and demand for these services will be.
The background evidence and information they have been provided with includes:
- The eight broad reasons why we are doing this, national and regional good practice and evidence.
- The wonderful, rich feedback we have received from our residents, healthcare professionals and various other stakeholders through our engagement.
- The current and projected future demand for our services and the capacity and the structure of our workforce that will be needed to deliver it, as provided by the NW London CSPC Data Group.
Many local residents have been kind enough to share their stories to illustrate both the good experiences and the challenges that people face when using community-based specialist palliative care services. We need to learn from their experiences and the feedback has been used in the NW London CSPC Model of Care Working Group meetings so it can directly influence the discussions that are being had on a topic-by-topic basis.
The minutes for the Model of Care Working Group’s meetings can be found here.
A summary of the review programme’s work is provided in the table below.
Scope of review programme work to date |
||
Task |
Considered by Model of Care Working Group? |
Further detail |
|
Defining what the core elements of care and service delivery are |
Yes |
The national service specification for palliative and end of life care PEOLC and the starting point for this work. The working group are further defining these based on our resident and population needs. |
|
Defining how much of these key elements we need |
Yes |
This isn’t covered in the national specification, but is critical if we are to make sure we are able to introduce a common core service across NW London. Note that ‘How much’ includes hours, staffing, capacity etc. |
|
Defining how services should be delivered |
Partially |
For example, we may want to define elements such as access (including geographical availability) but not how services are integrated at a local borough level. |
|
Defining where services are to be delivered |
No |
The NW London CSPC Model of Care Working Group will put forward some recommendations that will be included in the long-list of service change options that will be developed further following more engagement with the public and other stakeholders. These options will go through an appraisal process and be subject to public consultation if deemed necessary |
|
Who delivers elements |
No |
Future programme work once model of care and option have been agreed. |
|
How much it costs |
No |
Not considered at this stage. |