We would like to say thank you to everyone who attended the event.
Please see the presentation used in the meeting.
Summary of key themes and contributions
Participants expressed a strong commitment to ensuring that end-of-life care is compassionate, accessible, and equitable for all. There was widespread support for enhancing community-based services, improving access to specialist palliative care, and ensuring a more coordinated approach across boroughs. Many attendees acknowledged the dedication of healthcare professionals and the importance of continuous improvement to meet the evolving needs of patients and their families.
1. The need for a standardised and equitable service model
- Participants widely acknowledged inconsistencies in CSPC provision across the eight boroughs
- There was strong support for a model that ensures 24/7 access to specialist care, particularly for those who are not yet known to palliative care services
- Several contributors emphasised the need for earlier identification of palliative needs and better integration with primary care services.
2. Challenges with current care provision
- Personal testimonies highlighted gaps in care, including a lack of continuity and difficulties accessing pain management
- Concerns were raised regarding inappropriate care packages for terminal patients discharged from hospital
- Some participants reported inadequate training for generalist healthcare providers, leading to delays or mismanagement of end-of-life care.
3. Options for future care delivery
- Attendees from boroughs currently relying on Pembridge inpatient services expressed disappointment at its continued closure but acknowledged the practical challenges in staffing and maintaining such a facility.
4. Workforce and training gaps
- Contributors strongly advocated for enhanced training programs for healthcare staff, ensuring that generalist professionals can identify palliative care needs earlier
- There was a call for increased collaboration with hospices to provide training to generalist NHS staff
5. Inadequate support for informal carers and families
- Several personal accounts underscored the emotional and physical toll on carers, who often struggle to access support, particularly outside of normal service hours
- Bereavement support and psychological services were identified as areas requiring expansion and improvement.
6. The role of community-based and enhanced end-of-life care beds
- Hillingdon was recognised as a leader in implementing enhanced end-of-life care beds in nursing homes, which have helped reduce hospital admissions
- There was consensus that this model should be expanded across all boroughs to provide an alternative to hospital-based end-of-life care
- Contributors stressed the importance of ensuring these beds are well-supported by specialist teams.
7. Local infrastructure challenges and future planning
- The issue of long travel times to access inpatient care was raised, particularly for residents in South Hillingdon
- The potential sale of a local hospice building led to concerns about the future availability of hospice services in the borough
- NHS representatives assured attendees that alternative locations for inpatient services were being explored.
Frequently asked questions (FAQs)
1. What changes are being proposed to community specialist palliative care?
The NHS is proposing two models of care, both aiming to standardise community specialist palliative care across all boroughs. The preferred model (Option A) focuses on expanding community-based services, while Option B includes reopening the Pembridge inpatient unit.
2. Why is Pembridge specialist palliative care hospice inpatient unit not being prioritised for reopening?
Staffing shortages remain a significant barrier. Opening Pembridge would require recruiting 35 additional specialist staff, which is currently unfeasible without impacting other services.
3. Will community specialist palliative care be available 24/7?
Yes, the proposed model includes a 24/7 specialist palliative care telephone advice line for patients, carers, and healthcare professionals who are both known and unknown to specialist palliative care services.
4. How will these changes improve access to community specialist palliative care?
The model ensures:
- Increased availability of community pecialist palliative care nursing services across all boroughs.
- Improved access to psychological and bereavement support.
- Greater availability of Hospice at Home services.
- The introduction of enhanced end-of-life care beds to prevent unnecessary hospital admissions.
5. How will staff be trained to deliver better community specialist palliative care?
A comprehensive training program is being developed to enhance awareness and competency among generalist NHS staff. There will also be closer collaboration with hospices to improve workforce skills.
6. What support is available for families and informal carers?
The model aims to provide more assistance for carers navigating palliative care pathways, improve bereavement support and ensure easier access to psychological services.
7. What happens next?
The consultation period remains open for feedback.
An independent analysis of responses will inform the final decision-making business case.
Implementation of the agreed model is expected to begin in summer 2025, with a phased rollout across all boroughs.