Kensington and Chelsea and Westminster end of life webinar 12 July 2022

We would like to say thank you to everyone who attended the event.  Their thoughts and feedback will be used as evidence as we move forward to develop the future model of care.

View the recording of the meeting

View the presentation

Key points/questions raised

Pembridge inpatient unit – the attempts to recruit a palliative care consultant to allow for the opening of the in-patient unit were detailed by speakers. Issues were raised over calculating the number of people that would have used the Pembridge inpatient unit vs. travelling further to alternative providers of hospice services.

The experience of people with Learning Disabilities and whether the LeDeR review and lessons learnt had been considered within the review teams work – NWL conducted a literature review which looked at best practise in care provision and engagement with individuals with LD. The outcome of the literature review is on the NWL ICS website and it is in the interim engagement report. CLCH offers appropriate training and support to staff looking after residents in LD flats (care homes) and families and received positive reports on this.

Culture, religion and ethnicity – palliative care services need to take account of cultural/religious/ethnic considerations in the way services are provided. There needs to be an openness and willingness to personalise the service for patients, acknowledging that it won’t be possible to have, for example, a Chaplain or Iman etc formally in place at each location. However, linking providers with local faith groups to support training and awareness is something that can and should be developed.    

Engagement to date with North Kensington residents – this has indicated diverse views amongst residents on where they would like to die with the key point being choice. A majority do not wish to die in hospital, some wish to die at home, whilst others do not. Others would prefer a hospice environment but do not wish to have to travel (and their families/friends) have to travel to Wandsworth or St John’s Wood.

Dying at home vs. access to medicines – a local GP emphasised the challenges for residents wishing to die at home but experiencing difficulty in accessing medication, particularly at weekends and bank holidays. The NWL team confirmed that a new service had been commissioned during the COVID-19 outbreak to address this point and that a rota of community pharmacists is in place to provide 24/7 cover for those needing EOL medication. The details are available to GPs through the 111 service and the NWL team provided details of shortcut to bypass (*7) the initial phone options.

Communication with voluntary organisations to gather views from local people - NWL is continuing to work with Healthwatch to capture the views of local people and how to improve services. In the Bi-borough, there are different organisations supporting with engagement.

Multi-disciplinary team (MDT) meetings – a community matron from a residential home in K&C suggested it would be beneficial for a palliative care team representative to attend MDT meetings to help reduce hospitalisation and increase staff confidence to support the residents at home in last phase of life. It was also suggested that it would be helpful if the nutrition and dietetics team join these meetings.

Bereavement counselling services – it was suggested that these need improving, especially for carers. In Westminster, for example, there is no commissioned bereavement counselling service. The NWL team are looking at core service elements within the review, and this includes bereavement support services.

Advocacy services - there is a need for improved advocacy services, especially for patients with learning disabilities, at the last phase of life. Currently there is a shortage of advocates and a lack of resource.

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