Making a difference that will never be forgotten
Charly shares her story from the perspective of both a CNS nurse but also the sister of a patient. Charly explains the incredible difference that the specialist care nurses made so that she could be there for her sister at such a difficult time for her family.
In February, my sister suffered a short illness and died very quickly. As a family, we were in shock and disbelief that such a vibrant and healthy person could be taken away from us so quickly. We always thought that this happens to other families, not ours. I am the one who looks after people in this field, and now I was on the receiving end of the very care I give. My initial reaction was feeling like I needed to orchestrate every aspect of care, keeping in control and not letting go.
“Let us do this for you” came a gentle voice from one of my colleagues. So, I stepped back, let go and watched as, very efficiently, the ISPCT stepped into place.
The incredible work varies, including a gentle and dignified wash from our Health care assistants, which made the world of difference providing comfort to my sister. Extending to the expertise and knowledge of palliative care from our specialist responders who had a calm approach and always seemed to know what will work best. If it became challenging, instant access was obtained to a specialist doctor to discuss and come up with the best alternative plan. The clinical nurse specialists worked tirelessly putting plans into place to ensure that our family wishes were met. The entire time my sister was made to feel safe and in control of her illness whilst my family were reassured and guided through a very dark period. Letting me know what was happening but taking responsibility away from me so I could be a sister, a daughter, an aunt.
Making a difference that will never be forgotten.
Who we are
Not only did Covid 19 cause lockdown in the UK in March 2020, but the Community Palliative Care services became integrated, providing one service across LLR for all patients requiring specialist input.
The integrated service involved Leicestershire Partnership Trust (LPT), LOROS and to a lesser extent Marie Curie working together to provide Specialist Palliative Care and end of life care to patients in their usual place of residence. We are also commissioned to facilitate Rapid Discharges from acute hospitals for end of life care.
The key part of the integration of services was to provide a single point of contact. We now have a Coordination Centre which is manned by specialist nurses 8am-6pm, 7 days a week. Rapid Response is accessible until 10pm via SPA and OOH’s advice currently offered by LOROS.
All referrals go to the Coordination Centre for triage and are then allocated a visit or CNS if appropriate. If the referrals are triaged as not meeting ICSPC criteria the referral is directed to the appropriate service. Ensuring that all get seen by the most appropriate service. We accept referrals from all healthcare professionals and if a patient is discharged from the service, they can self-refer by calling Single point of Access (SPA).
The team consists of:
1 Matron (LPT), 1 Service Lead (LOROS).
25 Clinical Nurse Specialists (CNS) – based in localities, with an assigned group of GP practices. CNS’s see patients with uncontrolled symptoms or severe psychological distress anytime between diagnosis of a life limiting illness and death. They provide visits Monday- Friday 0900-1700.
11 Rapid Response Nurses who work 8am to 10pm providing complex symptom management and supporting patients and their families in the last days of life. This team are based at New Parks Health Centre and cover the whole of LLR.
11 Specialist HCA’s who provide personal care and reassurance to patients in the last days of life and support their families.
2 Community Consultants who are available for advice daily (Monday to Friday). They also provide outpatient appointments and domiciliary visit. They facilitate twice weekly meetings to discuss patients and provide regular education/training sessions for the team (Palliative Care Clinical Meetings).
We are supported by a small admin team from both LPT and LOROS and leads from all areas meet regularly.
Read more
Good news!
Congratulations to Mia Maxwell and Julia Crumley 2 of our CNS’s who recently successfully completed the European Certificate in Palliative and End of life Care
Congratulations to CNS Louise Bee to taking on the role of Practice Development within ICSPC, planning to support and upskill our nurses and work with wider Community Health Services to develop knowledge in Palliative Care
Congratulations to our wellbeing team (Priti Parekh and Elaine Wilkins) who have been were awarded LPT’s Wellbeing Champion Award in June this year
Michelle Law (LPT Matron) has been nominated for a Excellence in Leadership Award and Rapid Response Nurse Pretty Manyimo has been shortlisted for LPT’s Excellence in Research Award- we look forward to hearing the outcomes of these
Prescribing EOL medications
The LPT EOL group have been looking at improving the management of controlled drugs in the community following some concerns recently.
When you prescribe pre-emptive EOL medications to a patient please let us know through SPA with an authorisation attached.
A nurse will then record the medications safely on our drug record cards and ensure they are in a safe place in the patient’s home. This will enable the nurse to ‘eyeball’ the patient with an initial assessment and plan in their ongoing care. This will also help with reducing crisis calls and admissions into hospital because our community nursing teams will have sight of these patients who have potential to deteriorate.
LOROS Day Therapy
We have now opened our new Well-Being Hub in Day Therapy! This will be open on the 1st and 3rd Monday of each Month from 10am to 3pm.
There is a café selling meals and snacks, open to carers and patients
Wellbeing sessions each week
Complementary therapy
Crafts and support from volunteers
Please note: patients do not need to be referred, they can just turn up.
What is the Patient Monitoring Caseload?
Previously, patients who were admitted to inpatient settings would be discharged from the ICSPC caseload and we relied on patients/relatives or healthcare professionals to inform us when the patient had returned home. Unfortunately, there were gaps in this process as often we would not be informed of the patient returning home and this would cause times of crisis and distress for both the patient and their family.
In April 2021, we implemented the Patient Monitoring Caseload, which patients who are admitted to inpatient settings are moved to. This is monitored by the admin team lead regularly and allows for the patient to have a smooth and efficient transition back to CNS care upon their discharge to the community.
We are pleased to say that it has had a huge, positive impact on our patient experience.
To give some figures on this;
From January-June 2022, 424 patient admissions have been monitored where the patients were placed back on the ICSPC caseload upon discharge back to the community.
150 patients sadly died during their admission and their families received bereavement support from our team as we were aware of this happening.
Education Opportunities
Some great education opportunities are coming up- upcoming dates and costs TBC!
Recognition of Patient and Carer Psychological Needs- 1 day course
Based on Level 1 NICE Guidelines
Recognition of Psychological Needs of Patients and Carers- 5 day course
Based on Level 2 NICE Guidelines
The aim of these course are to provide self-confidence to work with the psychological and emotional needs of patients', families and carers with your day to day work and to support you in acknowledging your own limitations and self-care needs.
Psychological theory will be combined with personal skills to develop your understanding of how distress influences human behaviours
Considers how trauma manifests
Discusses how this knowledge can be used to hold patients and carers in their distress in an emotionally safe way
Reflects on the power of using language around illness differently
To register your interest in these courses and to find out more information please contact Valerie Olivant!
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