Treasures of the Baltic Sea - Shifting Sand Dunes - Discover Moving Landscapes
Shifting priorities: Moving care out of hospital and into the community
-
Upload
marie-curie-cancer-care -
Category
Healthcare
-
view
149 -
download
0
description
Transcript of Shifting priorities: Moving care out of hospital and into the community
![Page 1: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/1.jpg)
SHIFTING PRIORITIES: MOVING CARE OUT OF HOSPITALS
Dr Phil McCarvill17th November 2014 @MarieCuriePA
![Page 2: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/2.jpg)
MARIE CURIE
• Major UK end of life charity • Major service provider – Network of 2000 Nurses caring for
people in the last few hours and days of life – 1.3 million hours of nursing in 2012-13
• 9 hospices across the UK reach 8,000 people each year• Our services reached a total of 38,777 people in 2012-13• Major funder of academic and health service research with an
Open Access research policy • Working to influence policy and practice through our policy
and public affairs work.
![Page 3: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/3.jpg)
DELIVERING HIGH QUALITY SERVICES
![Page 4: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/4.jpg)
CHALLENGES & OPPORTUNITIES
• Ageing society – added pressures for end of life care
• Financial pressures – budgets reduced, greater pressure and need to deliver more for less and for more people
• Five Year Forward View
• Will all require us to do things radically differently
![Page 5: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/5.jpg)
WHAT PEOPLE WANT AT THE END OF LIFE
• Analysis of high quality studies – preferences for ‘home death’ range from 31% to 87% (PHE, What we know now 2013)
• VOICES Survey – 80% said that there relative had wanted to die at home
• Increase in number of people dying in their usual place of residence (43.7% in 2012 compared to 37.9% in 2008), rising again to 45% in 2013-14. But still a long way to go.
• Consensus that the majority do not want to die in hospital.
![Page 6: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/6.jpg)
HOSPITALS ARE NOT THE RIGHT PLACES FOR MOST PEOPLE TO DIE
• Majority of those who die in hospital often have no clinical need to be there
• For many units dying is not their core business
• The environment and other pressures do not lend themselves to specialist care for dying people
• Many people at the end of life end up in hospital because the wider health & social care system cannot move quick enough to put together the right pack of care to enable them to die in the place of their choice.
• The care they receive when they end up is perceived to be poorer than that in other settings.
6
![Page 7: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/7.jpg)
HOSPITALS ARE NOT THE RIGHT PLACES FOR MOST PEOPLE TO DIE
SOURCE: NATIONAL SURVEY OF BEREAVED PEOPLE, 2013
Place of Death % Rated Excellent or
Outstanding
Hospice 59
Home 53.2
Care Home 50.8
Hospital 32.7
![Page 8: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/8.jpg)
GREATER CONFIDENCE IN THE ABILITY OF COMMUNITY SERVICES TO DELIVER
• There seems to a concern in some quarters that about shifting resources because there are no guarantees that community services will be able to deliver
• We now have a growing evidence base which demonstrates that community services can and does deliver improved outcomes.
8
![Page 9: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/9.jpg)
CONFIDENCE IN THE COMMUNITY
Recent Evidence
• Nuffield Trust (2012) evaluation of Marie Curie Nursing Service which showed that access to MCNS helps reduce hospital use at the end of life
• Nuffield Trust (2014) – Exploring the cost of end of life care
9
![Page 10: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/10.jpg)
BETTER OUTCOMES FROM COMMUNITY-BASED INTERVENTIONS
10
Source: Nuffield Trust, The Impact of the Marie Curie Nursing Service on Place of Death and Hospital Use at the End of Life, 2012
![Page 11: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/11.jpg)
NUFFIELD TRUST EVALUATION OF THE MARIE CURIE NURSING SERVICE
11
Conclusion:
‘People who received Marie Curie Nursing Service care were much more likely to die at home, less likely to require hospital care and incurred significantly lower hospital costs’
![Page 12: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/12.jpg)
END OF LIFE
Nuffield Trust estimates that community end of life services could be nearly £500 per person cheaper:
“any increase in activity that might occur in primary care, community care and in social care activity as a result of reduced hospital bed days is likely to be very modest when considered against the entirety of care activity during the last months of life.”
12
![Page 13: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/13.jpg)
13
![Page 14: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/14.jpg)
WHAT THE SYSTEM NEEDS
• Over-reliance on hospital based care – with poorer outcomes
• The system cannot deliver as it is currently configured
• Evidence shows that most people do not want to die in hospital, do not need to be there & experience poorer care if they end up there
• Evidence should give us confidence to shift away from our current reliance on hospitals.
• Take advantage of the alignment of people want and what the system needs to bring about fundamental change.
14
![Page 15: Shifting priorities: Moving care out of hospital and into the community](https://reader033.fdocuments.in/reader033/viewer/2022042816/559654d21a28ab80768b46ba/html5/thumbnails/15.jpg)
THANK YOU FOLLOW US ON @MARIECURIEPA