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

Following the release of the initial proposed model of care in August 2023, we undertook an extensive period of engagement to hear the views and receive the feedback of our residents, health professionals and a broad range of local stakeholders.

A series of nine engagement events took place in September and October 2023 at which attendees had the opportunity to learn more about the model and comment on the proposals. We also received feedback via online surveys, email and in other face-to-face meetings.

Overall, there was good support for the proposed new model of care. We did hear some valuable challenges and constructive suggestions on how we might improve the model, which we committed to reflect in this revised version of the proposed new model of care. These included the following key themes:

  • Further information on the proposed enhanced end-of-life beds.
  • Addressing inequalities and disparities in access, outcomes and experiences of palliative care services.
  • Enhancing innovation and continuing to make improvements to specialist palliative care services alongside the implementation of the new model of care (including service navigation and co-ordination).
  • Improving leadership and governance.

In February 2024, we produced a revised new model of care featuring extensive changes to reflect these points. There are also various other more minor revisions and additions to reflect other points raised during public engagement. The revised new model of care features a full statement explaining these changes and highlighting of them within the document. The revised model can be seen here.

The initial proposed new model of care for community-based specialist palliative care for adults in NW London (August 2023)

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 NW London. We believe it offers the opportunity to improve the level and scope of community-based specialist palliative care in every borough in NW 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

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
Click here to view co-designig a new, improved model of care - one pager

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

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