Search results for ‘Subject term:"palliative care"’ Sort:
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Are you there?: reviewing specialist palliative care inpatient admissions criteria
- Authors:
- NATIONAL COUNCIL FOR PALLIATIVE CARE, HELP THE HOSPICES
- Publisher:
- National Council for Palliative Care
- Publication year:
- 2011
- Pagination:
- 15p.
- Place of publication:
- London
This discussion document, published by the National Council for Palliative Care and Help the Hospices, looks at the importance of using specialist palliative care beds in the most efficient way possible. It looks admission and discharge policies and processes and also highlights the relationship of specialist palliative care inpatient services with other services. Case studies are included, as are examples of different approaches to ensure services maintain quality care whilst maintaining efficiency, such as supportive discharge and out of hours services. Early recommendations are also included.
On the rocks
- Author:
- SMALL Neil
- Journal article citation:
- Health Service Journal, 2.4.98, 1998, p.35.
- Publisher:
- Emap Healthcare
Explains the effect of the proposed closure of the London Lighthouse on the hospice and palliative care movement.
Cost-effective commissioning of end of life care: analytical tool
- Author:
- PUBLIC HEALTH ENGLAND
- Publisher:
- Public Health England
- Publication year:
- 2017
- Place of publication:
- London
An economic tool to help commissioners in their decision-making for end of life care services. It explores the trade-offs between shifting end of life care out of secondary services and describes interventions that might be deployed to achieve such savings. Where evidence of the effectiveness (for example in reducing the use of acute care beds) of specific interventions is available, the tool allows users to model the impact of these interventions on their local data, to provide an estimate of the Return on Investment associated with that intervention. The primary, community and social care services included in the tool include: residential and nursing home care, inpatient hospice care, GP consultations, district nurse visits, care at home provided by a home care worker, informal care, community palliative nursing and voluntary care from third sector organisations. The tool is in the format of an excel spreadsheet. (Edited publisher abstract)
Independent evaluation of Electronic Palliative Care Coordination Systems (EPaCCS) in England: final report
- Author:
- WHOLE SYSTEMS PARTNERSHIP
- Publisher:
- Whole Systems Partnership
- Publication year:
- 2016
- Pagination:
- 83
- Place of publication:
- London
Independent evaluation of Electronic Palliative Care Co-ordination Systems (EPaCC) which are designed to support the co-ordination of end of life care once it is recognised that someone is likely to be at or near the last year of life. The system provides a shared local record for health and social care professionals, accessible across care boundaries, which provides access to key information about an individual. The aim of the evaluation was to examine the impact of EPaCCS on the experience of care towards and at the end of life, for patents, carers and staff and also look at evidence of its cost effectiveness. The evaluation draws on a range of publicly available qualitative and quantitative sources as well as in-depth work interviews with patients, carers and professional. Findings reported suggest that patients, carers and professionals in EPaCCS locations viewed co-ordination of care as both important and increasingly being realised. 'Systems leaders' also found EPaCCS as an important tool to improve the coordination of care and outcomes at the end of life. The evaluation also notes that to achieve full benefit from EPaCCS there is a need to continue to address contextual and cultural challenges, including the building of capability amongst staff, taking full advantage of technological advances and building strong teams that collaborate effectively across agencies, organisations and professions. (Edited publisher abstract)
Equity in the provision of palliative care in the UK: review of evidence
- Authors:
- DIXON Josie, et al
- Publisher:
- London School of Economics. Personal Social Services Research Unit
- Publication year:
- 2015
- Pagination:
- 148
This report provides a summary of available academic and statistical evidence on inequities in palliative care for adults across the UK. It identifies and explores systematic differences in access or outcomes, between geographical areas, settings or different groups of service-users, in the context of people’s different needs and preferences. The report also discusses the economic case for extending the reach of palliative care to those currently under-served, looking at the evidence on cost effectiveness and the costs of extending palliative care to those who would benefit from it but are not currently receiving it. The report draws on a wide-ranging and comprehensive review of research literature and nationally available data, and new multivariate analyses of data from the National Survey of Bereaved People in England, 2013. Key sections include: history of palliative care services and policy framework; palliative care need and preferences; access to care; pain and symptom control; quality and experience of care; place of death; and costs. The findings suggest that, despite a wide range of improvements in end of life and palliative care following the publication, in all four UK countries, of national end of life care strategies and their associated programmes, there still remain a range of inequities in provision. The report concludes by highlighting key themes and areas which require improvement, namely around: addressing unmet need; measuring and monitoring need; addressing confusion about roles and responsibilities; improving communication with patients and families; meeting the needs of people with non-cancer conditions; improving alternatives where home death is not possible or not preferred; ensuring equity in the provision of services for those from BAME groups; improving outcomes for people living in the most deprived areas; and making best use of resources. (Edited publisher abstract)
Exploring the cost of care at the end of life
- Authors:
- GEORGHIOU Theo, BARDSLEY Martin
- Publisher:
- Nuffield Trust
- Publication year:
- 2014
- Pagination:
- 30
- Place of publication:
- London
An analysis of the hospital and non-hospital costs for people in the last 90 days of life, using anonymised person-level datasets relating to GP contacts, community nursing, local authority-funded social care, hospice and hospital care. The study demonstrated that hospital costs were by far the largest cost elements of end-of-life care – care in the final three months of life averaged over £4,500 per person who died. The bulk of this cost was due to emergency hospital admissions. Hospital costs increased rapidly in the last few weeks of life. The research also explores whether reduced hospital activity and costs at the end of life were likely to be offset by increased care costs in other health and social care settings using the Marie Curie home-based palliative care nursing service. The results suggest that cost savings might be achievable if community-based support were made more widely available to help people to die in their own homes, where that was their preference. Given the finite resources available for health care, it is important that there is an understanding of the costs of end-of-life care. The report recognises that acquiring good-quality data surrounding costs for palliative care is challenging, especially as care services for those at the end of life are fragmented across many different providers. (Edited publisher abstract)
Community care is a means to a better end
- Author:
- SHAW David
- Journal article citation:
- Health Service Journal, 13.12.12, 2012, pp.23-25.
- Publisher:
- Emap Healthcare
Terminally ill people rarely want to die in hospital and many people's experience of end of life care in hospital is poor. Findings from a recent study from the Nuffield Trust, 'The impact of the Marie Curie Nursing Service on place of death and hospital use at the end of life', found that the Marie Curie Nursing service enables more people to die at home and reduces hospital admissions and costs. The article also highlights the success of the choice programme in Somerset which used a systems approach to develop end of life services. To support commissioners, Marie Curie has also developed a UK End of Life Care Atlas, as a web-based mapping tool which brings together data on end of life care across the health landscape.
Funding the right care and support for everyone: creating a fair and transparent funding system: the final report of the Palliative Care Funding Review
- Authors:
- HUGHES-HALLETT Tom, et al
- Publisher:
- Palliative Care Funding Review
- Publication year:
- 2011
- Pagination:
- 99p., bibliog.
- Place of publication:
- London
This independent review, commissioned in July 2010 by the Secretary of State for Health, was set up to examine the funding of dedicated palliative care for adults and children in England. The review consulted with over 760 individuals and 380 organisations across the sector. A later stage of the review also incorporated 334 contributions received via a website and work commissioned by King's College London. The report outlines the current funding system and the weaknesses in the current model. It then looks at how a new funding system could be created and how this funding mechanism could deliver better outcomes for patients. Chapter five sets out recommendations on what services should be included in the NHS palliative care tariff and what services the state should continue to support alongside society. Following chapters look at how many people need palliative care and those with unmet need, creating a new system which is cost effective, and building the system. The review's recommendations include: an NHS palliative care tariff which is based on need; a funding system which incentivises good outcomes for patients; the commissioning of integrated care packages which stimulate community services. These recommendations have three key aims to: create a fair and transparent funding system; deliver better outcomes for patients; and provide better value for the NHS
The potential cost savings of greater use of home- and hospice-based end of life care in England
- Authors:
- HATZIANDREU Evi, et al
- Publisher:
- Rand Corporation
- Publication year:
- 2008
- Pagination:
- 100p., bibliog.
- Place of publication:
- Santa Monica, CA
The objective of this study, commissioned by and prepared in collaboration with the National Audit Office (NAO), was to provide an estimate of the current financial impact of caring for patients during their last year of life and the potential implications of expansion of palliative care services. Its first phase reviewed the literature about end of life and palliative care for evidence of effectiveness and resource utilisation. The second phase was an economic analysis of end of life care in England, providing an overview of the current costs to the NHS for delivering services to patients, and modelling and quantifying the potential cost implications of decreasing reliance on acute care by higher levels of adoption of palliative care services. The implicit assumption is that the time patients spend in hospital could be reduced by transferring them to their preferred care setting at the end of their life, and that by providing end of life care in the community the number of unplanned emergency admissions and days spent in hospital could be decreased. Overall, the study results indicated that there is potential for palliative care services to reduce expenditure associated with hospitalisation while at the same time accommodating the expressed preferences of patients. The study is part of a broader Value for Money study that the NAO is undertaking into end of life care in England.
Interagency collaboration in human services: impact of formalization and intensity on effectiveness
- Author:
- NYLEN Ulrica
- Journal article citation:
- Public Administration, 85(1), 2007, pp.143-166.
- Publisher:
- Wiley
Interagency collaboration in human services production, it has been claimed, contributes to improved quality and/or reduced costs, but previous research on effectiveness from collaboration has failed to recognize that collaboration could be arranged in a multitude of ways. This paper investigates the effectiveness consequences of alternative collaboration arrangements. From a literature review, the degree of formalization and intensity, respectively, stand out as major aspects of collaboration. The impact on effectiveness from intensity and formalization was investigated through an explorative case study of collaboration projects in Sweden. The following projects are briefly discussed: delegation of nursing tasks to home-helps; joint work rehabilitation; specialist involvement in primary health care; local hospital beds; home-based medical care; hospice home care and institutionalized rehabilitation for the elderly. Results suggest that the particular combination of formalization and intensity determines the impact on effectiveness. Combining low intensity with medium high formalization into `an assignments reallocation strategy' of collaboration appears to have modest impact, whereas medium high intensity in combination with low formality, that is, `a commitment-based networking strategy', has a high potential to increase effectiveness. High intensity in combination with high formalization produces `a formalized team-building strategy', which is simultaneously promising and risky.