The proposed new model of care for community-based specialist palliative care for adults in NW London

Our community and our partners in the NHS, charitable hospices and local government have been instrumental in shaping the model of care and the range of services it is recommending is delivered in North West London (NW London). We believe it offers the opportunity to improve the level and scope of community-based specialist palliative care in every borough in North West London.

We would like to thank all the members of the NW London CSPC Model of Care Working Group and the wider patients, families, carers and other stakeholders for their feedback and suggestions that are so integral for the success of this programme.

We are incredibly grateful for the support and contributions we have received from local residents who have shared their individual stories and thoughts.  The new model of care builds on previous engagement and has been co-designed over the last year by a working group, which met 38 times, of NW London residents, along with clinicians, NHS providers and charitable hospices with the ultimate goal of making sure there is improved access to high quality services.

In our engagement and the work that we have carried out through the model of care working group, we have considered the needs of our diverse communities and those with protected characteristics including people who live with learning disabilities, and people who are experiencing homelessness and LGBTQI. in some cases, we carried out literature reviews and spoke to experts representing some of these communities. This insight was published in the engagement outcome report. Engagement will also continue and a full equality health impact assessment will be carried out in the future.

Click here to view co-designing a new, improved model of care - full document

Click here to view co-designing a new, improved model of care - summary

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This new model shows “what good care should look like” for adults across NW London. Some of these services already exist across all boroughs, while others are new additions and will level up the standard of care. This is particularly significant for boroughs where the services currently do not exist or there is significant variation for boroughs. 

The model covers a wide range of community-based specialist palliative care services that will help patients to stay in their own home or usual place of residence, whilst allowing them the flexibility to move to a different care setting if needed.

It increases the range and number of inpatient bed care options available by introducing enhanced end-of-life care beds, for people with less complex specialist palliative care needs who still require inpatient care. This is on top of the existing hospice inpatient beds currently in place and projected to be required over the next five to ten years.

The model also includes an extension of a number of existing services to level-up provision and availability across all eight NW London boroughs, including:

  • Extended provision of 24/7 telephone advice lines for existing and new patients
  • Extended days and hours of care provision by specialist teams
  • Increased support to care homes
  • Expansion of Hospice at Home services to all boroughs, supporting up to 24-hour care in patients’ homes
  • The introduction of new common standards for psychological and bereavement support services 
  • Expansion of lymphoedema services

We are tremendously pleased and grateful that so many local residents and those who have first-hand experience of the palliative and end of life care received in NW London have helped us in shaping this proposed new model over the last eighteen months.

With the support of our colleagues in both charitable and NHS providers, we would like to share this proposal with NW London residents and ask whether they agree that the model will improve and level-up community based specialist palliative care across our eight boroughs, helping us provide high-quality end of life care to patients.

During our engagement, people also emphasised the importance of making sure we had a trained workforce who understood the cultural and faith needs of our diverse community. Doing more to explain how good palliative and end of life care is about helping people live the best quality life they can. To understand the needs of people with long-term conditions such as dementia, heart disease and cancer to name a few. And to have bereavement support for their family and loved ones.

You can respond to the model of care by completing our simple survey or attending one of our three engagement events.  Please click and register for the event you would like to attend. Further details will follow nearer the date.

Engagement on the model of care will continue throughout the summer and early autumn.

The specific details of how the services will be organised and provided will be determined in the next phase of the programme, once the new care model is finalised, following this next period of engagement.

We are immensely grateful for your continued engagement and contributions which are vital to the success of this transformative initiative. We would also ask that you share this document widely.

If you have any questions, please do not hesitate to get in touch with us by emailing nhsnwl.endoflife@nhs.net

To understand whether we have the hospice inpatient beds needed to serve the inpatient needs of our population, we have undertaken an analysis of future demand and compared this with the capacity we currently have 

Click here to view the analysis.

Hospice in-patient bed provision currently works on the basis of catchment areas. In some cases, they overlap with the catchment area of other hospices. To understand how accessible the units are to our population, we undertook a travel mapping analysis.

Click here to view the travel mapping analysis

When we embarked on the review of community-based specialist palliative care one of the eight issues we needed to respond to was making sure that we developed services that met the future palliative care needs of NW London’s changing population.

In order to do this we committed to undertaking further demand modelling and population projections for a ten-year period to support future services modelling.

Click here to view the demand modelling and population projections.

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