Compassionate care for all - improving community specialist palliative care for adults in north west London

Public consultation 18 November 2024 to 24 February 2025

Please note that this consultation has no connection to the Assisted Dying Bill currently being discussed in the national media and UK Parliament.

We have called the consultation  ‘Compassionate care for all’.

Compassionate care for all is doing the best for patients, families and friends when they have a serious or life-limiting illnesses such as cancer and need the care and support to live the best possible life that their condition allows.

Compassionate care for all is making sure we have high quality and compassionate care whilst you at your most vulnerable during the last few months or weeks of life.

Compassionate care for all is knowing that all adults who live in north west London have equal access to the highly specialist care and support you get from our NHS and charitable hospices at home, in the community or if you need it a hospice bed.

What is community specialist palliative care?

Palliative care is the treatment and support provided to people who are terminally ill. It focuses on improving quality of life by managing symptoms, relieving pain and addressing any side-effects of a patient’s condition. It also provides emotional and practical support for patients, families and carers.

There is a difference between palliative care and end-of-life care. End-of-life care is a specific type of care for people nearing the final stages of their life. It aims to ensure comfort, dignity and support, managing symptoms and providing emotional and practical help.

Specialist care refers to the fact that the care is provided by palliative care specialists; ‘general palliative care’ is care provided by other professionals such as GPs, district nurses or care home staff.

Community specialist palliative care includes services for people outside of hospitals, such as in their homes, care homes, or hospices. General palliative care’ is care provided by other professionals such as GPs, district nurses or care home staff.

NHS North West London is proposing changes to improve adult community specialist palliative care services for people with serious or life-limiting illnesses. We want to hear your views on these proposed improvements, which focus on compassionate, accessible care for residents across our area.

The starting point

The review of adult community specialist palliative care services began in late 2021 and seeks to respond to identified issues by delivering services that:

• meet people’s needs and wishes
• are fair and accessible to everyone across North West London
• deliver better care and improve outcomes for patients and their families.

Since then we have met and worked with patients, families and carers as well as our colleagues from charitable and NHS care providers to help us create this proposal to improve the care and services available to all residents in north West London.

We know that people care deeply about their local services, whether charitable hospice or NHS, and how they support local residents, families and carers at what is the most difficult of times.

We are consulting on options on how we can deliver the following service improvements

The proposals aim to address a wide range of needs, including:

• A specialist nursing team available 12 hours a day, 7 days a week, across all boroughs.
• 24/7 telephone support for palliative care advice for all north west London residents.
• “Hospice at Home” services available around the clock.
• Specialist palliative care outpatient clinics in each borough.
• Improved access to psychological and bereavement support for families at local hospices.
• Expanded lymphoedema services for conditions related to both cancer and non-cancer causes.  Lymphoedema is a long-term condition where a build-up of lymph fluid in your body's soft tissues causes swelling.
• 46 new enhanced end-of-life care beds across north west London, providing additional options for those whose needs can’t be met at home but don’t require hospice-level inpatient care.
• Maintaining the 57 consultant-led hospice inpatient beds currently available, which our analysis shows will meet community needs over the next five years.

Following a long-listing, short-listing, appraisal and assurance process, we will be consulting on two options:

• Option A (preferred option): Fully implement the proposed model, including 46 new enhanced end-of-life care beds, while maintaining the number of existing hospice beds without reopening the Pembridge Palliative Care Inpatient Unit beds. This option would be easier and quicker to implement and benefit more north west London residents as a whole.
• Option B: Fully implement the proposed model, including 46 new enhanced end-of-life care beds and reopen Pembridge Palliative Care Inpatient Unit beds inpatient beds. This would require a reduction in hospice beds elsewhere and have a longer implementation timeline due to the need to recruit specialist palliative care consultant cover and 35 additional staff.