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Bereavement Care in Cumbria and Lancashire Palliative Link Nurse Study Day

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Title: Bereavement Care in Cumbria and Lancashire Palliative Link Nurse Study Day


1
Bereavement Care in Cumbria and
Lancashire Palliative Link Nurse Study
Day Crooklands Hotel, Kendal, LA7 7NW
Wendy Lewis-Cordwell Macmillan Network
Bereavement Lead 15th November 2012
2
What is the project?
To encourage the development of and equitable and
high quality bereavement service across the whole
of Lancashire South Cumbria Network area
building on existing good practice and national
guidance
3
NW End of Life Care Model
Last days
First days
Advancing disease
Increasing decline
Bereavement
DEATH
1 year
6 months
1 year
Grief / Bereavement can begin at the
diagnosis of any life-limiting disease
4
Develop Bereavement Services in Cumbria and
Lancashire
  • Map current level of services
  • Undertake a gap analysis of such provision
  • Identify improvements in services and
    environments
  • Introduce agreed minimum standards
  • Encourage collaborative working
  • Respond Implement National Guidance
  • Develop Education/Training
  • Identify and share Best Practice
  • Be accessible to patients, families, carers,
    visitors, staff as the project demands

5
BEREAVEMENT CARE DEVELOPMENT CUMBRIA LANCASHIRE
20.054 deaths per annum Cumbria Lancs
(Source Office for National Statistics and
Research Agency 2010)
6
Suicide facts Above National Average in
Cumbria (data published by Demos 2011)
  • 2009 England 4,390
  • 16.1 Suicides for every 100,000 males
  • 4.08 Suicides for every 100,000 females
  • One death by suicide every 2 hours
  • Data Supplied by PCTs Coroners
  • Central Lancashire 32.5 per annum
  • Cumbria 52 per annum
  • North Lancashire 38.7 annum
  • Cancer patients the risk of suicide increases
    by more than TEN times in the week after
    diagnosis.

7
Scope the area. The Bereavement Services
Directory
8
Scope the area. 5 Localities
9
Scope the area. The Bereavement Services
Directory
10
Network Specification for Bereavement Services in
Hospitals
  • Standards of bereavement care that should be in
    place, to support the development of an
    equitable, high quality coordinated service
    across all hospitals
  • Gap Analysis sent to all five acute trusts for
    completion
  • Key recommendations
  • Senior Managerial support
  • Bereavement Office
  • Ward
  • Chaplaincy Service
  • Mortuary Service
  • Information
  • Policy and Procedure
  • Monitor and Measure the Service

11
When a person dies - October 2011 Guidance for
professionals on developing bereavement services
  • There is some value in locating bereavement
    centres within a mortuary
  • Salisbury NHS Foundation Trust
  • Providing - One stop
  • Hospital mortuary and bereavement services can
    also be available for advice to professionals
  • Provide a quiet, dignified and respectful
    environment
  • Information and advice given, improving the
    quality of the experience
  • Reducing the overall amount of time taken in
    completing and issuing the relevant certificates

12
Principles of good practice
  • Privacy Dignity
  • Time to mortuary
  • Communication
  • Work in Partnership - with families and with
    others e.g. coroners, religious representatives
    voluntary organisations
  • Environment and Facilities
  • Staff Training and Development
  • Staff Support and supervision
  • Review and Audit

13
Who is involved when a person dies?
14
For you in Your Loss Questionnaire Responses
  • Staff on the ward have many challenges but they
    handle all with patience, skill and compassion
  • The booklet helped me to focus. Guiding me in how
    to do the practicalities
  • I was allowed to stay longer than other visitors.
    The ward staff were wonderful, I will never
    forget their kindness
  • Maybe a simpler way of getting into the hospital
    at night
  • Forget confidentiality obsession and tell ones
    loved one how ill their relative is
  • Unexpected delay in being able to register the
    death, doctor not available to sign medical
    certificate cause of death on night duty!

15
Network Specification for Bereavement Services in
Hospitals
  • Standards of bereavement care that should be in
    place, to support the development of an
    equitable, high quality coordinated service
    across all hospitals
  • Gap Analysis sent to all five acute trusts for
    completion
  • Key recommendations
  • Senior Managerial support
  • Bereavement Office
  • Ward
  • Chaplaincy Service
  • Mortuary Service
  • Information
  • Policy and Procedure
  • Monitor and Measure the Service

16
Network Specification for Bereavement Services in
Care Homes
  • Every care home should embrace the principles of
    dignity and respect, when providing a bereavement
    service and include the following
  • Gap Analysis sent to all care homes for
    completion
  • 5 Key recommendations
  • Policy and Procedures
  • Care After Death
  • Information and Support
  • Quality of care after death, audit and review
  • Training and Education

17
Small Changes . Make a big difference......
18
In Your Loss Folder
  • Bereavement Folder to be given to all families /
    carers with the MCCD in Cumbria and Lancashire
  • 50,0000 to be distributed to Hospitals, Hospices,
    GPs, Care Homes, Registrars, etc
  • Initial supply delivered Nov 2012
  • Feedback from organisations Dec 2012
  • Further supply February 2013 (Each organisation
    will receive two years supply)
  • Organisations can insert their contact details
    plus any additional local information

19
When Someone has Died
1000.0000 printed Distributed across Cumbria Lancashire Nov/Jan2013
20
In Your Loss Folder - Distribution
21
Dignity, Respect, Sensitivity, Communication!
  • Are we still leaving bereaved families without
    information about what to do next!!!


22
Cumbria and Lancashire Bereavement Forum
  • Inaugural meeting 10th August at Preston Business
    Centre
  • Role of the group
  • Promote Consistency across all localities
  • Identify opportunities of integrated working
  • Learn from others and share best practice
  • Influence local and national development of
    bereavement across ALL sectors
  • Meet 4 times per year (meetings to be rotated
    across Cumbria and Lancashire)
  • Next meeting Friday 23rd November 2012 at Eden
    Valley Hospice, Carlisle

23
National Issues..
24
Liverpool Care Pathway Norman Lamb Health
Minister will listen to concerns BBC News
01.11.2012
  • IT IS "COMPLETELY WRONG" FOR TERMINALLY ILL
    PATIENTS TO BE PUT ON A "PATHWAY" TO DEATH
    WITHOUT RELATIVES BEING CONSULTED
  • Mr Lamb also defended the practice of paying
    hospitals for using the pathway
  • I want to hear where things have gone wrong. I
    want to ensure we address that absolutely, but a
    lot of good things have happened in recent years
    to improve the experience at the end of life.
  • Where there have been problems, I would say
    that it has not been with the LCP but due to lack
    of communication
  • Conservative Peer Baroness Knight, is calling for
    an inquiry into suggestions the LCP has
    accelerated some peoples death, said she had
    heard of cases where people were deprived of
    water without consent

25
Views sought on strengthening NHS
Constitution
  • Proposals to strengthen the NHS Constitution
    are set out for public consultation today, with
    the NHS, patients and public are all being asked
    to respond
  • Patients, their families and carers should be
    fully involved in all discussions and decisions
    about their care and treatment, including their
    end of life care
  • The closing date for comments is 28 January 2013
  • Responses to the consultation will feed into a
    revised version of the NHS Constitution, which
    will be published by April 2013
  • http//www.endoflifecareforadults.nhs.uk/news/all/
    views-sought-on-strengthening-nhs-constitution

26
New NHS Mandate 13.11.2012 identifies EoLC as a
priority area...
  • The first Mandate between the Government and
    the NHS Commissioning Board, setting out the
    ambitions for the health service for the next two
    years, has been published today
  • The NHS will be measured, for the first time, by
    how well it achieves the things that really
    matter to people.
  • Preventing people from dying prematurely
  • Enhancing the quality of life for people with
    long-term conditions
  • Helping people to recover from episodes of ill
    health or following injury
  • Ensuring that people have a positive experience
    of care
  • Treating and caring for people in a safe
    environment and protecting them from avoidable
    harm
  • http//www.dh.gov.uk/health/2012/11/nhs-mandate/

27
Death Certification Reform .
28
People, Process Technology in the Current System
29
Death Certification Reforms - Issues
  • April 2014 - new date for implementation of
    service instead of October 2013
  • Transfer old payments to the new system and
    simply add burials
  • Will the public perceive this as imposing a
    death tax
  • How will the LAs cope with non payment - will
    bailiffs be used?
  • Pilots in hospitals, community, urban and rural
    area have been successful
  • Extend pilots on 2 sites - to include the
    sensitivities of neonatal and child deaths

30
Will the new reforms improve death statistics?
31
(No Transcript)
32
National Working Alliance For Bereavement
  • The Alliance brings together professional and
    volunteer organisations operating across all
    sections of the bereavement service workforce
    including
  • NHS Bereavement officers
  • Medical Examiner officers
  • Mortuary and pathology staff
  • Hospital chaplains
  • Coroner officers
  • Hospice bereavement coordinators
  • Bereavement researchers
  • Bereavement volunteers
  • Experts in the field
  • The Alliance had been proposed to provide an
    overarching body for the relevant professional
    and volunteer organisations working with bereaved
    people in order to provide a shared view.
  • The Alliance will provide a collective voice to
    the Government, other professionals and to
    members of the public.

33
Gold Standard Bereavement Care Training for
Professionals
  • Gold Standard Bereavement Care Training
  • Health and Social Care Professionals who come
    into contact with the bereaved
  • Roll out as a national programme
  • Build on the previously delivered
  • BSA When a patient dies training
  • Cruse Bereavement Awareness and Support Training
  • Good practice benchmark
  • Initial pilot plus 5 additional pilots
  • Completed by March 2013

34
The Bereavement Pathway Website?
35
Care of the Dying is URGENT CARE
36
Dignity, Respect, Sensitivity
  • Treat the deceased with the dignity and respect
    as you would have done when alive particularly
    when moving / handing them
  • Is there any specific information needed from the
    families / carers / others close to the patient
    i.e. religious practices?
  • Be aware of your own attitude, behaviour, and the
    words you use
  • Be aware that issues and incidents around death
    and dying impact the grieving process

37
REMEMBER
  • When someone dies you only get ONE change to get
    it right.
  • Get it wrong and the family will remember what
    has gone wrong forever.

38
Any Questions
Thank you
39
Further information
  • Please contact
  • Wendy Lewis-Cordwell
  • Macmillan Network Bereavement
  • Co-ordinator
  • T 01772 647 037/041
  • M 07766137210
  • email
  • wendy.lewis-cordwell_at_lsccn.nhs.uk
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