Follow this link for resource pack for managing patients with palliative or end of life care in community/care homes created by The End of life Executive Group (CCG leads, BHRUT palliative care team, Saint Francis Hospice, NELFT) and local BHR GP's (Dr M Goyal, Dr R Crowley and Dr Rai). This link takes you to the NELCA Coronavirus GP intranet.
CMC is a clinical NHS service that supports patients in urgent care situations. Together with their clinicians, patients may record their preferences and wishes within an electronic personalised urgent care plan that also includes clinical information and relevant medical history. This care plan can be viewed by all the healthcare professional teams involved in the patient’s care twenty four hours a day, seven days a week and ensures that the patient is at the heart of their own healthcare. For more information go to the CMC page within this intranet.
Referrals Hub - Referrals are all received electronically (not by fax), via a generic nhs.net address: NELCSU.firstname.lastname@example.org. The referral form is on their website https://www.sfh.org.uk/refer-a-patient. The form is at the bottom of that page. Referrals are pick up seven days a week. Between 9:00am-4:00pm the referral will be read within two hours. They try to make contact with anyone who is at home within 24 hours, but please indicate URGENT on the referral if the patient is in crisis/rapidly deteriorating, and supply key clinical information on the form/attach recent clinical information to help us prioritise. Recent blood results, drugs and allergies really help.
Inpatient Unit – They have kept 16 beds safe and operational, and can stretch more if someone is in need but able to mobilise safely/independently. The IPU is being heavily used so that there can be a wait; but reviewed every day in an effort to identify the person in most need and to ensure help for those who have to wait. They allow visitors, though visiting is limited and careful. When they need to adjust, they ensure they know. The average length of an inpatient stay is 12 days, but they have seen many more people needing short interventions, and more discharges back home. They cannot be a long stay option due to bed pressures, and for the same reason they have no pure respite beds.
Specialist Community and Crisis Support - Their specialist Advice Line is, as always, open, 24/7. The number is 01708 758643. Please do ring for any palliative/end of life care advice or support; they are happy to give advice and support whether or not they know the patient. The CNSs are doing more by phone due to the huge volume of referrals and advice line calls, as well as for COVID-19 safety reasons, but their CNSs and doctors are still home visiting, focussing on crisis situations and on those who just cannot manage connecting by phone. A few have prescribing ability now. In a crisis situation, if they can help by prescribing crisis symptom control medications they will. As always, our District Nurse colleagues are key partners in care. They visit care home residents if they are in difficulty, with the support of the care home.
Saint Francis Hospice is a centre of excellence in the care of those with life limiting illnesses. Our team of specialist consultants, doctors, nurses and health care assistants provide practical and emotional support for adults of all ages and give specialist bereavement support to family members from as young as 20 months.
Most of the people we care for like to stay in their own homes, therefore we provide support that allows them to do that. At times when this is not possible or when patients prefer the comfort of being in a clinical environment, we bring them into our hospice for specialist care and control of symptoms; over half of these patients are able to return home again.
Our teams provide care in the home, inpatient care at the hospice, day care at our centre together with a full range of therapies and treatments. This care extends beyond physical treatment of symptoms; we consider the emotional, psychological, spiritual and social needs of our patients, their families, children and carers.
Please see downloads for GP update leaflets from the Hospice.
Age UK Redbridge, Barking and Havering are offering a service to support end of life patients. Details of what the service offers and how to refer your patients are included in the below letter for GPs and patients, if you think they will welcome the support. If you have any questions please contact Andreea Albu at Age UK on 020 8220 6000 or via email.
Child Bereavement UK offers face-to-face support for families where a baby or child has died or where children and young people (up to the age of 25) are bereaved. The charity supports families who are facing bereavement, where a child isn’t expected to live, or where children and young people are facing the death of someone significant in their lives. The services are provided free of charge and are offered by trained bereavement support practitioners. GPs can refer patients and families can self-refer. For more information call 020 8519 7025 or email.
Please follow this link to the dedicated Coronavirus GP intranet for the latest End of life updates and information on COVID-19 related issues.
Please find links below to a series of video’s produced by Guy’s and St Thomas’ NHS Foundation Trust
This video explains Cardiopulmonary Resuscitation (CPR) and DNACPR orders
This video is intended to support patients' and carers' understanding of treatment escalation planning and options for preferred place of care.
This video explains what is meant by uncertain recovery and advises patients and carers to consider what is most important to them, including place of care and acceptable levels of treatment.
This video aims to help patients and carers understand how decisions are made when offering treatment and how a patient's capacity to be involved in decision making is assessed.