North West London - How are we going to deliver the new model of care for community-based specialist palliative care afternoon 30 November 2023

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

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Jane Wheeler (JW), Director of Local Care, NHS North West London (NW London) gave an introduction and presentation covering the development of the new model of care, the potential options for its delivery, and the decision making process.

Key points raised by attendees

  • Wanted to understand where the new model of care’s proposed enhanced end-of-life care will be located in future.
  • Whether nursing homes have capacity to support the proposed enhanced end-of-life care beds and what their current occupancy rates are across NW London.
  • Further detail on the vision/model for Hospice@Home services.
  • The need for a clearer definition of what we mean by Hospice@Home and what the proposed service involves (referencing page 24 of the Hansford Review)
  • How Hospice@Home overlaps with other services e.g. Marie Curie services (in some boroughs), NHS, Continuing Healthcare-funded services, community palliative care services.
  • Concerns over potential cost of Hospice@Home services (and possible duplication of other services).
  • The challenge posed by an aging workforce within district nursing and the follow-on impact this has on service delivery to patients.
  • The lack of bedded unit provision in the south of Hillingdon (as the only bedded unit is in the north of the borough).
  • Why references to Pembridge are included on the Hillingdon slides when Pembridge is not relevant to Hillingdon residents.
  • The need to bring more members of the public to engagement meetings (like this) and improve communication/engagement with local residents to help enable this.
  • The need for materials on the model of care (slides, briefings etc.) to also make clear what will not change – for example the slides do not reference the role of St Luke’s.
  • The importance of noting and making clear people’s ability to change their mind on their end-of-life care and the need for good advanced care planning which starts as early as possible.
  • Whether we have calculated the current level of provision vs the estimated demand for our community-based specialist palliative care services.
  • The need for a shorter summary of what we propose and what this means for each borough.
  • What the overall cost envelope for the model of care is and how much it may rely on the charitable hospice sector.
  • The need to keep services open and operating in areas where you have people living in poverty and that there are many black and Asian minorities living in these areas needing such services.
  • The need to address why there are people from some cultural backgrounds not accessing services.
  • The importance of treating people and patients as individuals.
  • The difficulties in getting people from the south of the Hillingdon borough (which has a diverse population e.g. 37 languages spoken in Heathrow Villages) to engage with a review such as this.
  • The extension of 24/7 advice lines to patients ‘not known’ by services was welcomed.
  • The assistance that the HPAL Medindex website (hosted by Harlington Hospice) can provide to patients/carers/clinicians in identifying currently available services and other guidelines and resources.

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