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.
The North West London Community Specialist Palliative Care consultation event brought together residents, healthcare professionals, and stakeholders to discuss proposed service improvements. Participants shared support for service enhancements while raising concerns about equity, accessibility, workforce challenges, and transparency in decision-making.
Summary of key themes and contributions
1. Equity and geographical distribution of services
- Many welcomed the introduction of enhanced end-of-life care beds across all boroughs, providing a new option for patients unable to remain at home.
- Several participants highlighted disparities between boroughs, particularly in Westminster and Kensington & Chelsea, where concerns were raised about a perceived loss of funding and choice compared to boroughs such as Hillingdon.
- There was widespread discussion about whether enhanced end-of-life care beds could be provided at Pembridge to protect its future and ensure local provision in an area with high need.
2. Communication and engagement issues
- Positive: Attendees appreciated the various consultation events and online discussions, recognising efforts to involve different communities.
- Some residents expressed frustration over a lack of follow-up communication after previous engagement events, raising doubts about the transparency and responsiveness of the consultation process.
- Questions were raised about whether all demographics had been given equal opportunity to participate, particularly regarding digital exclusion and outreach to minority communities.
3. Workforce and staffing challenges
- The commitment to providing 12-hour specialist palliative care nursing teams (8AM-8PM) across all boroughs was widely supported.
- Participants questioned how the new beds and services would be staffed given existing shortages in palliative care professionals. Many worried that recruitment issues could lead to future service instability, as seen with Pembridge Palliative Care Inpatient Unit continuing suspension.
4. Future of Pembridge Palliative Care Inpatient Unit and hospice choice
- Expanding hospice access across north west London was seen as an improvement, allowing patients to choose a facility based on family proximity rather than borough boundaries.
- A significant number of attendees strongly advocated for reopening Pembridge inpatient beds, arguing that its NHS funding made it a more sustainable option compared to other partially charitable-funded hospices.
- Some participants felt that Option A (proceeding with the new model without reopening Pembridge) was being promoted over Option B (including Pembridge), rather than allowing for a balanced discussion of both options.
5. Quality and accessibility of enhanced end-of-life care beds
- The introduction of 46 new enhanced care beds was seen as a step forward in addressing gaps in current service provision.
- Many questioned where these beds would be placed and whether they would provide the same level of specialist support as traditional hospice inpatient units.
- Some worried that placing these beds in care homes without strong oversight would compromise the quality of care, leading to patient distress and unmet needs.
6. Timeline and implementation concerns
- The phased implementation plan was recognised as a structured approach to achieving long-term service improvements.
- Some feared that delays in decision-making and recruitment could prolong the gaps in specialist community palliative care services, particularly in areas already facing shortages.
- There were calls for greater clarity on how decisions would be made post-consultation and how public feedback would be incorporated into the final plan.
Frequently asked questions
1. Why are enhanced end-of-life care beds being introduced?
These beds aim to fill the gap between home-based palliative care and hospice admission. They will support patients who cannot remain at home but do not require the level of medical intervention provided by hospice inpatient units.
2. Where will these enhanced beds be located?
Each borough will determine suitable locations in consultation with residents and stakeholders. Placement will consider existing infrastructure, workforce availability, and local demand.
3. Can the Pembridge Palliative Care Centre be used for enhanced end-of-life care beds?
Yes, this is a possibility that will be explored further following the consultation outcome. Community input will be considered in deciding where to place these beds.
4. How will staffing shortages be addressed?
Efforts are underway to improve recruitment and retention, including enhanced training for community-based palliative care teams and competitive employment packages for specialist staff.
5. How will hospice access be improved?
Patients will have greater flexibility in choosing a hospice, allowing them to access inpatient care at facilities outside their immediate borough.
6. How will patient and family concerns be addressed?
A 24/7 palliative care advice line will be introduced to support patients and caregivers. Enhanced bereavement and psychological support services will also be made available.
7. What happens after the consultation?
- Consultation closes on 24 February 2025.
- An independent analysis of responses will be conducted by 3ST, a voluntary sector organisation representing north west London.
- The ICB board will review a decision-making business case based on consultation findings.
- Phased implementation of the new model will begin later in 2025.
- Continued engagement with stakeholders and communities to refine service details.
For further details and to submit feedback, visit: NW London ICB Consultation Page