We would like to say thank you to everyone who attended the event. If you have any questions or feedback, please email nhsnwl.endoflife@nhs.net
Please see the presentation used in the meeting.
Summary of key discussions and points raised
- Purpose and scope of the consultation
- Contributors appreciated the focus on reducing postcode lotteries in care access, particularly for residents of Kensington and Chelsea and Westminster, who currently face inconsistencies in service availability
- Acknowledgment of the diverse and multicultural population in North Kensington highlighted the need for culturally sensitive services tailored to local communities
- Concerns were raised about whether the consultation adequately addressed the specific needs of these areas, especially in light of the historical closure of the Pembridge inpatient unit.
2. Proposed models of care
- The introduction of enhanced end-of-life care beds was broadly welcomed as a step toward improving local care options, particularly in Kensington and Chelsea
- Concern was expressed about the impact of not reopening Pembridge Palliative Care Inpatient Unit beds. Attendees emphasised that this facility historically served some of the most deprived areas, including North Kensington, and its absence has created a gap in equitable service provision
- Participants from Westminster noted that transport to existing hospice facilities, such as Royal Trinity Hospice and St. John’s Hospice, is challenging, particularly for families reliant on public transport.
3. Enhanced end-of-life care beds
- Stakeholders welcomed the proposal to introduce four enhanced end-of-life care beds for Kensington and Chelsea and five for Westminster, acknowledging the potential to improve local access
- Concerns around ensuring these beds are located close to the boroughs they serve, particularly in North Kensington, where residents face socioeconomic challenges and higher levels of health inequality.
- Contributors stressed the importance of involving local communities in decisions about the placement and operation of these beds.
4. Travel accessibility
- Many appreciated the emphasis on minimising travel burdens by placing enhanced care beds closer to communities
- Westminster residents noted that travel to hospices in other boroughs, such as Hillingdon, is particularly burdensome, with some journeys requiring multiple buses and taking over an hour
- Suggestions included re-evaluating transport accessibility and providing specific support for families, such as parking permits or transport subsidies.
5. Equity and inclusion in Westminster and Kensington and Chelsea
- Contributors noted efforts to engage with multicultural communities in North Kensington, including outreach to faith-based and ethnic minority groups
- Concerns were raised about whether current engagement efforts sufficiently reached residents in Westminster and North Kensington, particularly those who may lack access to digital platforms
- Attendees highlighted the legacy of the Grenfell tragedy in North Kensington, stressing the need for culturally competent care and trust-building initiatives in this area.
6. Broader palliative care concerns specific to Westminster and Kensington and Chelsea
- Attendees supported proposals to enhance psychological and bereavement support, particularly for families in North Kensington, where the need for trauma-informed care is significant
- Concerns were raised about the potential strain on general palliative care services if specialist care improvements do not address wider systemic gaps.
Frequently asked questions (FAQs)
1. What are enhanced end-of-life beds, and how do they differ from hospice beds?
- Enhanced end-of-life beds
- Location to be determined but likely to be in a care home, nursing home or NHS community site
- Staffed by medical professional teams with additional training in palliative care
- Supported by weekly ward rounds from specialist palliative care teams, including consultants and specialist nurses
- Designed for patients needing more support than can be provided at home but not requiring intensive hospice care.
- Hospice beds
- Located in dedicated hospice facilities
- Residents will be able to access specialist hospice inpatient beds at all north west London hospices, not just the one closest to them
- Provide 24/7 specialist care with multidisciplinary teams, including doctors, nurses, and therapists
- Focus on managing complex symptoms, offering psychological support, and ensuring intensive end-of-life care.
2. Why is Pembridge not being reopened under Option A, and how does this impact North Kensington?
- Challenges Include:
- Recruitment of specialist staff, including a consultant and 35 additional personnel, which would take significant time and resources
- Reopening Pembridge would require closing beds in other charitable and NHS hospices, impacting the services they deliver.
- There would be a detrimental financial impact on charitable hospices if they were to lose income
- The consultation has identified other areas such as South Hillingdon with greater unmet need.
Pembridge Palliative Care Centre will continue to provide a wide range of services including 24/7 specialist telephone advice line, community specialist palliative care nursing and therapy teams and other services.
3. How will travel challenges for Westminster and North Kensington residents be addressed?
- Feedback on travel challenges will inform the placement of enhanced end-of-life beds
- Locations will prioritise accessibility, especially for families reliant on public transport.
- Additional measures, such as parking permits and public transport evaluations, are under consideration
- Residents will be able to access specialist hospice inpatient beds at all north west London hospices, not just the one closest to them.
4. How will culturally sensitive services be ensured in Westminster and North Kensington?
- Services will incorporate feedback from faith-based and ethnic minority groups. Specific training in cultural competency will be provided to staff to better serve diverse communities.
5. What support will be available for bereaved families in these boroughs?
- Expanded bereavement services, including trauma-informed care, will be prioritised, particularly in North Kensington. Psychological support will also be made more accessible in Westminster and Kensington and Chelsea.