Agenda item

Palliative and End of Life Care Strategy

The Coventry and Warwickshire Integrated Care System is developing a joint all age strategy for Palliative and End of Life Care, on which the Committee’s feedback is sought.

 

Minutes:

The Committee received a report and presentation on the draft Coventry and Warwickshire Palliative and End of Life Care (PEoLC) Strategy, on which the Committee’s feedback and support was sought. The item was introduced by Jamie Soden, Deputy Chief Nurse with a presentation from Kathryn Drysdale. They were supported by Kate Hoddell of the ICB and Katie Herbert (WCC and SWFT).

 

The presentation by Kathryn Drysdale covered the following areas:

 

  • What is Palliative and End of Life Care?This was an all-age strategy for Coventry and Warwickshire.
  • There had been extensive collaboration across the local NHS system and with relevant partners in all sectors, to understand current challenges and work together to make improvements.
  • An outline of the approach undertaken through an overarching partnership board, with four place-based groups feeding in local information.
  • The aim and vision of the strategy, to provide a delivery plan and to raise the profile of this service area.
  • The Strategy would cover a five-year period commencing in January 2024. Detail was provided on the communication plan, the two-year delivery plan, equalities aspects and areas of focus based on need. This included a focus on underserved communities, building relationships with communities and co-production. 
  • Our Priorities: What we want to do.
    • Providing information - a focus on identification, early intervention and support.
    • Access to timely PEoLC and support throughout for all diverse communities.
    • Support for people diagnosed with life limiting conditions and those who matter to them.
    • Improve the quality of personalised care and support planning, through education and training for all.
    • Deliver a sustainable system of integrated care.
  • The National Framework and the six ambitions for PEoLC. These were: being seen as an individual, getting fair access to care, maximising comfort and wellbeing, coordinated care, all staff being prepared to care and community support.
  • How the strategy was developed. A slide showing the co-production, the engagement with stakeholders, along with meetings, surveys, and group discussions. Data was provided on the engagement undertaken, raising the profile and importance of EoLC.
  • Health Inequalities in Coventry and Warwickshire. Some communities had poorer access to information, services and planning for EoLC. Details were provided of the specific groups affected particularly young carers, veterans and South Asian women.  
  • Population Health Management. A need to understand the current system, the population, socio-economic and demographic factors both now and in the future. This would help to determine workforce requirements, given the known challenges currently.
  • How we will deliver improvement. A need for seamless care across settings, clear referral pathways, pro-active personalised care, collaboration and clear communication.
  • Programmes through which we will work. This included care collaboratives, a community integrator model, the Warwickshire Community Recovery Service and a review of the continuing health care fast track system.
  • Delivery Plan for the period January 2024 – December 2026. This included areas of focus for each of the five priority areas reported above.
  • Remaining timeline for the strategy.

 

 

The following areas were discussed:

 

  • A member noted the passing reference to veterans. It would have been helpful to have more specific reference to veterans in both the documents and presentation.
  • The transition for those with life limiting conditions into palliative care. The twelve-month period referenced seemed too constricting. The point was acknowledged by Kathryn Drysdale, with the rationale for this timeframe within the two-year delivery plan being explained. It may be that this would be reviewed on an individual basis. It was made clear this applied to adults with a different approach being used for children and young people. 
  • A member asked about the PEoLC facilities available at Manor Court in Nuneaton. This would be researched, and a response circulated to the Committee.
  • Regarding EoLC services in the community, some carers were not trained emotionally to support family members. Home care staff provided a key role in communities and often did not receive the recognition they deserved. The strategy did not make sufficient reference to the need to uplift training for home carers. 
  • Kathryn Drysdale spoke of the planned education and training framework, which would be for NHS professionals, domiciliary care workers, volunteers, community groups and the general public. It would include competencies for relevant people, but also education and communication skills for volunteers in group environments to give assurance to people being supported. It would include liaison with the private providers of domiciliary care services on training and core competencies. Where possible, existing courses would be made available free of charge to this cohort for example via video conference. 
  • Discussion about the coordination of appointments for PEoL patients attending clinics. A pilot scheme was underway where patients visited a day unit and saw a range of specialists depending on their needs and symptoms. They were usually via a GP referral the day before, with urgent appointments on the same day. It was questioned if this coordination reduced the numbers of appointments available. An example was given to show the benefit this could have for patients ensuring they received the required care. The approach was welcomed by the councillor. The current pilot scheme was due to be operated for another two more months and its success would then be assessed. 
  • The strategy was considered to be informative and ambitious. There was a lot of work to do but no additional funding, so it was questioned how realistic it was to achieve the aims within five years. The member asked what barriers there were to success. Kathryn replied that all options were being considered. Examples were given of a funding application to Macmillan, some monies from NHS England and thinking ‘outside the box’ to link funding streams. The palliative care workforce was very dedicated, with staff going above and beyond. The local system was invested with good support from partners too. There was reference to the JSNA findings and work with population health too. The scale of the task was recognised but was considered achievable through collaboration. Jamie Soden added that the five-year term was not the end of the process. There needed to be an honest assessment of the current position and work required. As delivery progressed there should be realistic ‘stretch’ targets focussed on the priority areas. There was confidence that significant progress would be made over the initial two and five-year periods. There would be just as many challenges for the subsequent delivery plan and strategy. It was a big challenge, but there would be realism and transparency in what could be achieved.

 

In closing the item, the Chair noted the importance of this and all items on the agenda each of which could take a full meeting. He thanked the presenters also noting the reference to the JSNA and the value of that work.

Supporting documents: