End of life services

What is palliative care?

Palliative care aims to improve the quality of care of patients who are living with a life shortening illness.  It also helps the significant others that are close to the patient. Palliative care is available at any point during a life shortening illness, not just when patients are nearing the end of their life.

End of life care in this context refers to patients expected to be in the last year of life up to and including care in the last days of life.

Palliative care aims to reduce and relieve the symptoms of an illness which is serious and progressing. This illness could be cancer, advanced neurological disease, or poor function of important organs, such as heart, lung or kidneys.

The goal of palliative care is to achieve the best possible quality of life for patients and to help with the concerns of patients, families and carers.

An individualised care planning approach is used at any stage of the illness (from last year to last days of life). All healthcare workers can provide palliative care where appropriate; however, where symptoms and needs are complex a referral to the Specialist Palliative Care Services will be required.

Palliative care is provided at two distinct levels of care: those providing the day-to-day care to patients – such as General Practitioners (GP) and Community Nurses – and those who specialise in palliative care – the Specialist Palliative Care Team.

Our Specialist palliative care team

Our specialist palliative care team are here to support adults over the age of 18 who have life limiting illnesses that require specialist support. The Team aims to provide advice and support to patients, family, friends and carers. They also provide advice and liaise directly with the GP, consultants and other professionals involved in the patient’s care (such as

the District Nurses). The team all have advanced or specialist palliative care skills and consists of Consultants in palliative medicine, Clinical Nurse Specialists, local hospice staff, social worker.

The team work in partnership with your health care professionals within primary care, acute care and the local hospices. Your GP or hospital consultant will remain responsible for your medical care unless you are an inpatient at either hospice.

What can we help with?

• A specialist assessment of your individual needs
• We provide advice and support on physical symptoms (pain, nausea, breathlessness etc) that may be of concern to you
• Time for you and your family and carers to talk through thoughts and feelings about your illness
• Help and support for your future care
• We can offer advice and support for your family and / or carers
• We can provide information about sources of other support you may require, e.g. financial, spiritual, social etc
• We can liaise with your local hospice services for inpatient, outpatient, or day hospice care, as appropriate
• We can give you the opportunity to explore your support and care at end of life.

Working with our partners across northern Lincolnshire

We are working with our healthcare community partners across northern Lincolnshire to ensure we provide the best possible, streamlined end of life care to our patients, carers and their families.

We have been working closely with: North and North East Lincolnshire Clinical Commissioning Groups; East Midland Ambulance Service; Rotherham, Doncaster and South Humber NHS Foundation Trust; local councils; Lindsey Lodge Hospice in Scunthorpe; St Andrew’s Hospice in Grimsby, Focus; Care Plus and Navigo.

Together we have developed a Northern Lincolnshire End of Life Strategy which sets out an ambitious five year framework which focuses on how we can provide care for people nearing the end of life so we can ensure they get the right care, at the right time from the right people.

There are several key themes to the strategy but essentially it is about:

• Identifying people who are nearing the end of their life
• Staff supporting patients and those important to them to have honest and sensitive conversations about their wishes.
• Making sure every patient has a care plan that meets their needs and is regularly reviewed
• Recording those wishes on a ReSPECT document and an Electronic Palliative Care Co-ordination System (EPaCCS) record.

What is ReSPECT?

ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a nationally developed process led by the Resuscitation Council (UK).

ReSPECT creates personalised recommendations for a person’s clinical care in a future emergency, where they may be unable to make or express choices.

It is designed to allow patients greater influence on what happens to them, and that their wishes are carried out appropriately, should they ever find themselves in an emergency situation where they are not able to express their wants and/or needs.

ReSPECT can record preferences and recommendations for emergency situations, whatever stage of life the patient is at, and should not be limited just to those who are approaching end of life. It should be an important consideration for those with significant frailty or chronic progressive long-term conditions.

Dr Kate Wood, Medical Director and Consultant in Anaesthesia for Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) said: “ReSPECT gives patients more control over their care, and reassures them that their views are being taken into account when decisions are made about their treatment.

“In an emergency situation, staff must make rapid decisions about the care and treatment of an individual and there may not be time to have detailed discussions in a planned or sensitive way. It’s incredibly important to have these conversations early with patients to record their preferences for emergency situations. This ensures staff know how the patient wants to be treated, if at that point they are unable to make their wishes known, so their decisions can be honoured.”

Dr Yousef Adcock, Palliative Medicine Consultant for NLaG said: “Crucially, ReSPECT encourages wider open discussion about treatments that should be considered, as well as those that are not wanted or would not work, and should lead to agreed recommendations being made between the patient and healthcare professionals.”

To find out more about ReSPECT visit the Respect website.  

What is EPaCCS?

The Electronic Palliative Care Co-ordination System (EPaCCS) is an online solution aiming to improve the delivery of end of life care, by ensuring the wishes of patients nearing the end of their lives, are known and can be accessed easily across different health and care settings.

EPaCCS enables the recording and sharing of a patient’s care preferences and key details about their care at the end of life and is being used by GP practices, hospitals, community, hospices, out-of-hours and NHS 111.

We are also working with Yorkshire Ambulance Service and East Midlands Ambulance Service to make EPaCCS available to 999 services.

Further information about EPaCCS is available on the Humber, Coast and Vale Partnership website.