End of life care and carers

This domain has three complementary but not necessarily overlapping components.  Our plans focus on:

  • Meeting people’s end of life care preferences
  • Supporting the health and well-being of carers
  • Improving the health outcomes associated with cancers

Commissioning end of life care services

During 2014/15 we have worked regionally on the development of the care for the dying documentation, replacing the Liverpool Care pathway.  The Care for the Dying documentation has been piloted throughout Northumberland.  We have a prime contract in place for our entire end of life services which is held by Northumbria Healthcare NHS Trust; this has enabled all providers of care at the end of life to work more closely together providing more seamless care for patients at the end of their lives.    

Through support from public health colleagues, we have identified the top 5 cancers within Northumberland, with lung cancer being our most prevalent, and issues identified around early diagnosis.  Through collaborative working with Northumbria and our cancer lead GP we have provided primary care with additional information regarding symptoms to look for as well as information from public health to be made available to practice waiting rooms to increase patient awareness.

We continue to work with “Carers Northumberland” to roll out support to GP practices in identification and support for carers to improve health and wellbeing.  Work has been carried out to focus attention on young carers, with the development of a young carer’s reference group.

Our priorities for 2015/16 are: 

  • Continuing the single pathway for patients who are at the end of their lives.  This includes rolling out the care pathway documentation that we have developed and focussing on reducing the number of people on the pathway, who die in hospital.  This is already a flagship programme in the CCG
  • We have a carers’ strategy in place and are working on improving our support to carers including through the making personal health budgets available
  • Northumberland CCG is committed to using clinical evidence to define its priorities – and has used the evidence about the top five cancers in the county to shape its work going forward; we plan to focus on each of the five cancers in turn.  As described within the public health and prevention domain description, we have increased bowel screening take up in a sample of our population by 10% and will be rolling this out across the county; similarly we are working on increasing cervical screening uptake through the ‘think pink’ approach

Financial recovery in end of life care

The prime provider contract has secured financial stability in the end of life care domain over the last two years, negating the impact of demographic growth in full. 

The financial recovery to be achieved during 2015/16 is recorded through the Better Care Fund programme and is detailed in the unplanned care section of this commissioning plan to avoid any double counting.

The financial implications of increased and earlier cancer detection will not be realised within a 12 month period and are therefore not modelled into our financial forecasts.

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