Memorandum by Shropshire Palliative Care
at Home Scheme (PC 7)
The Shropshire Palliative Care at
Home is a three year pilot scheme running from September 2003.
It has been set up with a grant from New Opportunities Fund, providing
nursing care for people who have a life threatening illness such
as Cancer, End Stage Cardiac and Respiratory Failure, Multiple
Sclerosis, Motor Neurone Disease, and CJD who have expressed a
wish to remain at home during the last 3-4 weeks of life.
It covers a population of 156,000
people from a total population of approx 495,000 (which includes
Shropshire County PCT, Telford and Wrekin and Powys.) The areas
we cover consists of the urban and rural. The rural area was chosen
because of the deprivation of nursing services after 4.30pm. The
age group we cover is from 18 years. It is reasonable to expect
referrals of around 180 patients a year.
The service provides nursing care
for the patient over any two hour period and above during the
day and night cover for a nine hour shift. It is hoped to offer
volunteer support in the future to support families in a more
The staffing of the service is done
with qualified and unqualified staff, one wholetime equivalent
staff nurse, contracted hours and the rest are bank staff. Obtaining
commitment from bank staff has been a problem, due to the nature
of bank and having the freedom to choose when to work. The service
works closely with Marie Curie service, endeavouring to give patients
longer cover when appropriate.
Meetings take place every three months
linking with Shropshire County PCG, Macmillian, Marie Curie, Gold
Standard Framework, Lead Cancer Nurse, Carers Contact and and
other interested parties. Monthly meetings take place with an
operational group/steering group to discuss issues related directly
to the service.
Looking to the future in providing Palliative
Care at Home to the whole population of Shropshire the following
need to be taken into account:
Out of Hours Pharmacy support within
the patient catchment area.
Involving all GPs in Gold Standard
Out of Hours district nursing cover.
Training for specialist nurses to
give appropriate care when needed.
Employing and retaining staff.
Provide equality of care across the
county and to all age groups.