Issue - meetings

- Mike Wilkerson, Chief Executive, Rotherham Hospice

Mike Wilkerson, Chief Executive, Rotherham Hospice, stated that he had been invited to the Board to address how the Board could help deliver end of life care and was pleased to see the inclusion of “Dying Well” in the Joint Health and Wellbeing Strategy.

The end of life experience for some was not always appropriate; patients were sometimes admitted to Casualty when it would have been better for them to have remained at home.

Discussion ensued with the following issues raised/highlighted:-

-        There had been stories in the press recently about Liverpool Care Pathway.  It was used in the Hospice and by the Rotherham Foundation Trust as well as in people’s homes

-        The vast majority of people wanted to remain at home to die but that was not being delivered

-        Care packages (including Liverpool Care Pathway) had been thought out very carefully and adapted to the patient.  The patient and their carer(s) signed up to it

-        Feedback from the Patient Representative Group was good - it allowed people to die with dignity and ideally at home

-        Very effective tool for the last days of a patient’s live and allowed families to be actively involved in the care

-        Dying was 1 of the remaining taboo subjects and people should be encouraged to talk about it and what they wanted to happen when their time came

-        There should be a common approach

-        As well as the medical aspect there were the emotional and practical issues, such as wills and probate, which were not talked about and assumption that everyone knew what to do and where to go.  A package of care encompassing all the aspects was required

-        The Pathway was really a checklist/reference point which highlighted the important elements to address for patients and carers

-        Rotherham Case Management pilot for End of Life Care for those most at risk of admission to hospital

-        The Hospice was working with the CCG on Integrated End of Life pathway

-        Acknowledgement that some died in hospital because they were frightened to die at home or their carers were frightened/could not cope

Brian James felt that there was a need for a discussion/review on how partner agencies could improve co-ordination around this topic.  Robin Carlisle reported that the Unscheduled Care Group had carried out such a review in the Summer, the results of which were to be submitted to the Group shortly.

Resolved:-  (1)  That the inclusion of “Dying Well” in the Joint Health and Wellbeing Strategy be noted.

(2)  That the outcome of the Unscheduled Care Group review be submitted to a future meeting of the Board.