Transforming End of Life Care in Acute Hospitals - plenary presentation from Professor Bee Wee, NHS England

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Working Together to Transform End
of Life Care in Acute Hospitals
Central Hall Westminster
18th November 2015

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Working together
to transform end
of life care in
acute hospitals
Prof Bee Wee
NCD for End of Life Care
18th November 2015

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Wider context
New models of care – range of vanguards
NHS England Business Plan priorities
Initiatives for improving:
integration
personalised care and control
Support for improvements:
organisation level
System level

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Acute hospitals
• ‘Transform’ Programme:
• 5 core enablers
• What next?
• National audit – care of the dying adult
• CQC – end of life care theme
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Metrics
• Place of death
• Extent to which preference met: place of death, place of
care, other preferences
• Experience of care: patient, carer (current), carer (recall),
staff
• Other measures
• Time spent in hospital / out of hospital
• Number of unscheduled admissions
• Investigations in last week of life?
• Others?

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Data and information
• National EoLC Intelligence Network
• National survey of bereaved people: VOICES-SF
• National audit of dying in hospital
• Reversal in trend of increasing proportion of deaths
taking place in hospitals
• Economic Intelligence Unit – UK ranked top

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National Survey of Bereaved People
(VOICES-SF)
• 75% rated overall quality of care as outstanding, excellent
or good
• 10% rated care as poor
• 69% of deaths in hospital rated as outstanding, excellent
or good
• 79% at home; 82% in care homes; 83% in hospices
• 33% perceived hospital services not working well with GP
and other out-of-hospital services

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National Survey of Bereaved People
(VOICES-SF): inequities
• 49% of deaths due to cancer – reported to have
outstanding/excellent care:
• 39% - from cardiovascular disease
• 40% - from other diseases
• Those living in most deprived areas had more reports
of care being fair/poor: 30% vs 21%

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‘How to’…..
• Learning from everybody’s
insights
• Learning from each other
• ‘Buddies and peers’
• Route to success:
‘How to’ guide

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Dual task for hospitals
• Improve care for people in acute hospitals
• Improve integration and handover with community-
based services and other hospitals
21/12/2015

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Improving Quality in End of Life Care in
Acute Hospitals
Core enablers
‘Building on
the Best’
(Macmillan/
NCPC)

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