End of Life Volunteer Companionship Service

� The Volunteer department was receiving frequent calls from various Wards in the Trust asking if a volunteer could sit with a dying patient who didn’t have family present

� In October 2011 the VSM was approached by former patient carer who had recently attended an Opcare9 Conference - “Optimising care of the dying in the 21st Century”.

Early stages of the initiative

The following facts became apparent on meeting with the Palliative Care Team:

� Approximately 60% of patients spend their last days of life in an acute hospital

� Aintree University Hospital has approximately 1300 deaths annually

� Recent VOICES survey of bereaved relatives highlighted that the quality of end of life care for patients in an acute setting falls significantly behind the level of care in other settings e.g. hospice

Taking the idea to the Palliative Care Team

� Palliative Care department were really keen to use volunteer support to improve end of life care provided at Aintree

� Steering Group was formed consisting of:� Palliative Care Consultant

� Clinical Nurse Specialist Palliative Care

� Patient Carer Representative

� Voluntary Services Manager

� Business Case written to secure funding

� Received £5604.00 funding for the service from Merseyside & Cheshire Cancer Care Network End of Life and Palliative Care Education Group (for all patients at end of life, not just those with Cancer)

� Volunteer role description identified

� 20 suitable volunteers chosen by VSM (17 proceeded)

� Selected 5 pilot Wards to offer service to

� Looked at support available for the volunteers – Volunteer Manager, P. Care Team, Assistant Clinical Psychologist

� Identified appropriate training requirements – (followed guidance by Merseyside & Cheshire Cancer Care Network)

� Wrote policies, prepared documentation, set up data base to record findings. Prepared evaluation documentation

� Set up 3 day Training Course for the volunteers

Moving the project forward …

� Met with Matrons, Ward Managers and Nursing staff from pilot wards

� Identified who would make referrals at Ward level

� Attended Trust Divisional Meetings

� Prepared promotional materials detailing what the scheme was offering, how to access the service bleep number etc.

� Informed Medical staff

Advertising the service

� Put together a volunteer resource handbook which included:

• Procedure for the service

• Copy of Promotional material circulated

• Volunteer Role Description

• Volunteer contact details

• Reflective Diary

• Patient data entry form

• The Trust’s bereavement information booklet

• End of Life the facts booklet – Macmillan support

� Met again with Ward staff on the 5 pilot Wards

Getting Ready to Start …

On 14th May, 2012 the service was launched on 5 pilot wards from 8.00 am to 8.00 pm Monday to Friday

� Put a robust support system in place for volunteers

� Regular 1:1 meetings with Voluntary Services Manager

� Monthly meetings with Assistant Clinical Psychologist and 1:1 meetings when required

� Palliative Care Team on hand for extra support if required

� Steering Group met on a monthly basis

Volunteer Support

� Initial resistance from Nursing staff

� Concern from Trust Chaplains about the role

� Emotional aspect of the role

� Lack of understanding of the service by Nursing staff

� Volunteers feeling okay to leave a patient/family at the end of their shift

Challenges along the way

2012 Media Coverage by Daily Mail re: Liverpool Care Pathway

The biggest challenge of all

� Evaluation at ward level showed that staff had faith in the volunteer companions.

They found them to be courteous and respectful and felt confident in offering their

service to patients and their families

� Volunteer Companions felt that a number of ward staff did not understand their

role.

� Not all ward staff would encourage volunteer support if the patient had a family

member/carer present

� Evaluation of 3 day volunteer training course was mostly positive but volunteers

felt that the session delivered on spirituality did not provide them with enough

information to carry out the role

� Completed family/carer evaluation forms were positive and the first family

member to access the service acknowledged the support she had received in a

thank you note.

Findings at the end of 3 month pilot

� 4 further volunteer training courses have been organised (trained 61 volunteer companions in total)

� Existing volunteers are acting as mentors and offering support to newly trained volunteer Companions

� Service is now operational Trust wide (across all 36 Wards) –this has gradually expanded as more volunteers have been trained

� The service is having a significant impact on the quality of end of life service that is delivered within the Trust. 374 patients (or a member of their family) have accessed the service to date

Current Status

� The service was awarded “Runner Up” in the Patients’ Choice Quality Awards

2012

� Winner - Trust Excellence awards in the “Partnerships” category 2013

� A number of articles have been published in the local press 2012-14

� Published in the Aintree News (internal magazine) May 2013 to mark the

service’s first birthday

� Radio Merseyside coverage for the whole of Dying Matters week in May 2013

� An End of Life Journal is very interested in publishing the service and an article

has been put together, to be submitted in the next few weeks

� 2 members of the Department of Health, a representative from NESTA, 4 NHS

Trusts and 3 Hospices have visited Aintree to discuss the service

Awards & Recognition

� To continue to recruit and train volunteers, with a view to expanding the service even further to a 24 hour, seven day service

� Provide on-going support for volunteer companions

� Offer support , advice and encouragement to other Trusts/organisations who may wish to set up an EOL volunteer companionship service

Looking to the Future

“How people die remains in the memory of those who live on”

Dame Cicely Saunders, Nurse Physician, Writer and Founder of

Hospice Movement (1918-2005)