RBKC Adult Social Care & Health Select Committee - 29 November 2022

Partners from the North West London Integrated Care System attended the Royal Borough of Kensington and Chelsea adult Social Care and Health Select Committee on Tuesday 29 November 2022 to brief Councillors on the current position of the programme and answered questions. You can see the papers here and recording of the meeting here.

A summary of the discussion is below.

Detailed discussions centred on the future of Pembridge Palliative Care Inpatient Unit.  Committee members reiterated local residents wish to have beds nearby, citing the example of families and carers not having the ability to care for someone at home or someone living alone. Cllrs wanted to understand the reasons why the unit had not been able to open following suspension in 2018 and the steps that had been taken to recruit a specialist palliative care consultant or overcome the hurdles that were preventing it reopening.

  • Our starting point is that if we could recruit a specialist palliative care consultant we would reopen the unit but we have failed to do so. There is a national shortage of specialist staff and our hospices have had their own problems recruiting which is why they have not been able to support Pembridge. There is recognition that the current situation also hinders recruitment

Committee members wanted to understand what the key factors would be in determining whether it would stay open and the impact on Kensington and Chelsea residents if it did not reopen and what the options would be moving forward. 

  • The key factors would be the eight reasons that we set out in the Issues Paper published in November 2019. 
  • What jumps out is workforce as there is a national shortage of specialist palliative care staff which is other professionals financial sustainability of the system  
  •  Individualised needs of patients – especially the younger cohort. For instance, for many people care homes are their home and usual place of residence. 
  • In the end its deliverability. We can’t say we can do something if there is no chance that we can deliver it.
  • This is also a North West London review and we need to make sure there is equal access across the area plus ensuring we are reaching all our communities which we are just not doing now.

Committee members also wanted to understand why there were empty beds and the impact the closure of Pembridge, the number of patients who had went elsewhere as a result and their experience.  Also, whilst understanding that palliative care was much more than just inpatient beds, what the projected growth in need would mean in terms of beds?

  • We need to factor Covid in as it was safer to care for people in their own home plus the fact we are caring for more people in their own home which is where the model of care is developing.
  • A lot of the feedback in engagement sessions is about access to district nurses who do the bulk of end of life care and their GPs and that activity and trend to care for people in their own home has increased.
  • The idea is to have a range of bedded care on offer including in care homes, because as we have said there is a lack of specialist palliative care inpatient beds. But, what we can do is increasingly wrap our services around the care home, which will help prevent people going in to hospital – which is what is happening at the moment.
  • It’s also important to remember that inpatient beds are very specialist beds with set criteria for intensive support. A local person may want a bed but even if there was a local facility would not mean they would automatically get a bed.  That’s why it’s important the model will provide more access to different types of beds that will more support the patient’s needs.
  • Looking at projected growth in need, we need to make sure we have the beds and that may be inpatient beds but may be a different type of beds – recognising the importance of having local access.

​​​​​​​​​​​​​​Expressed concern at the time the review is taking and the need to bring certainty to residents.

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