Select Committee on Health Written Evidence


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 practical way.

    —  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 Framework.

    —  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.

February 2004

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Prepared 26 July 2004