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
1. Purpose and scope of the consultation
- Stakeholders expressed broad support for the ambition to create equitable and culturally sensitive services
- Contributors praised the structured approach to addressing historical disparities in access to specialist care
- Some contributors highlighted the importance of focusing on the green bubble (specialist palliative care) as a critical step toward systemic improvement, while others expressed concern about the exclusion of broader palliative care needs.
2. Proposed Models of Care
- Several contributors expressed optimism about the inclusion of enhanced end-of-life care beds, noting their potential to bridge care gaps for patients who do not need intensive hospice care
- There was strong support for improving overall capacity and accessibility, although some contributors emphasised the importance of reopening Pembridge Palliative Care Inpatient Unit beds to serve deprived areas like North Kensington.
- Some contributors recognised the practicality and speed of implementation under Option A.
3. Enhanced end-of-life care beds
- Contributors widely welcomed the introduction of enhanced end-of-life care beds as a creative solution to address patients' needs and reduce reliance on hospice inpatient beds
- Some contributors stressed the need for clear operational details, including locations, funding, and staffing, to ensure success
- Suggestions included designing enhanced end-of-life care beds to provide privacy and comfort for patients, especially in shared facilities.
4. Travel accessibility
- Many contributors appreciated the effort to analyse travel times and account for transport challenges in planning future services
- Concerns were raised that the travel analysis was not detailed enough and did not take into account wait times for public transport, especially buses.
- Also, families’ reliance on public transport and the burden of long journeys, particularly for daily visits including
- Concerns were raised about parking and parking charges and the impact on patients and families visiting hospices.
5. Equity and inclusion
- Contributors commended the proactive outreach to underserved communities, noting the importance of culturally sensitive services
- There was strong support for initiatives to address the needs of homeless individuals and for ensuring that services reflect the diversity of NW London’s population.
6. Broader palliative care concerns
- While the focus of the consultation is on specialist community palliative care, contributors highlighted the importance of broader palliative care services, such as rapid-response teams and enhanced home care
- Several contributors recognised the consultation’s potential to improve care pathways and reduce hospital admissions.
Frequently asked questions (FAQs)
1. What is the difference between hospice beds and enhanced 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. How will enhanced beds be distributed and funded?
- Their distribution will be based on population needs, with proposed numbers per borough ranging from 4–9 beds. Final locations will be decided after the public consultation closed and through a locally-led implementation process
- Funding with be NHS and continuing healthcare-funded, not reliant on charitable funding.
3. Why is Pembridge not being reopened under Option A?
- 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.
4. How will transport challenges be addressed?
- Feedback on travel challenges will inform the placement of enhanced end-of-life beds
- New locations will prioritise accessibility, especially for families reliant on public transport
- Residents will be able to access specialist hospice inpatient beds at all north west London hospices, not just the one closest to them.
5. How does the model address workforce challenges?
- Plans include recruitment drives, training programs, and collaboration with hospices to enhance workforce capacity.
6. How will the model support underserved communities?
- Focus on culturally sensitive services and proactive outreach to vulnerable populations.