More terminally-ill patients have chance to die at home

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MORE terminally-ill patients are to have the opportunity to die at home thanks to a new scheme aimed at speeding up their discharge from hospital.

Eleven nursing assistants have been recruited to work on the new fast track service, led by Marie Curie Cancer Care, and have been specially trained, not just in palliative care, but also all the other tasks that make it possible for patients to return home, from organising medication to shopping and laundry.

The scheme means dying patients will no longer have to wait for a “social care package” to be drawn up with the NHS and council before they are allowed to leave hospital – a process which can take weeks, and means they may end up dying in hospital against their wishes.

Instead, the new nursing assistants will step in to swiftly provide the social care their patients need, meaning they can leave hospital without waiting.

The scheme, which is the first of its kind in the UK, has been funded by Marie Curie and NHS Lothian, with each providing £100,000, while St Columba’s Hospice has provided the training for the new staff. If it is successful, it could be rolled out in other parts of the country.

Medical director for Marie Curie Edinburgh Hospice Dr David Oxenham said: “We’ve looked after a number of people already, and we anticipate that we’ll probably be able to look after 150 to 200 people a year and support them to be at home where otherwise they would have been in the hospital. Sometimes palliative care is urgent care, and when it’s urgent then you need to move quickly.

“That’s why we’re so pleased that NHS Lothian identified this as something that they would want to support and Marie Curie were able to match that and say, ‘Yes we’ll get on and do it’.”

He said coordinating all aspects of a patient’s social care package could take time, involving liason between the NHS and already-busy council services.

“The challenge is sometimes to get all of that up and running and if we can say, ‘No, we’ll just come and do it’, that gives the other services time to get themselves organised, because they’re already running at full speed. We can say, ‘We’ll do this and we’ll do it now because it needs to be done now.’”

Nurse director for NHS Lothian Melanie Hornett added: “We know that some people may prefer to spend their final days in their own home or community rather than in hospital, and this service will help to ensure we are able to give a greater choice to our patients.

“It will also enable us to provide more patients coming to the end of their lives with care that concentrates on relieving symptoms and giving physical, social, psychological and spiritual support.”

The new staff will provide an extra 8500 hours of care per year across the Lothians, working with people during the last two or three weeks of their life.

At present, 42 per cent of all deaths in the Lothians occur in acute hospitals.

sgyford@edinburghnews.com