The Transforming End of Life Care Team at University College Hospitals NHS Foundation Trust (UCLH) is comprised of Clinical Nurse Specialists, a lead senior nurse, project manager, consultant in Specialist Palliative Care and quality improvement fellow (a doctor).
Together we strive to ensure that all patients and those close to them receive high quality, personalised care during all stages of any life-threatening illness, including the last days of life. We support staff to work as a team to deliver this care with kindness and compassion in order to maximise comfort and well-being.
We do this by:
- Educating staff at all levels about identifying someone entering the last days of their life and how to support and provide high quality care for these patients.
- Supporting relatives and those closest to the person who is in their last days of life, for more information please see this leaflet: Care in the last days of life
- Offering space and time to debrief about the emotional impact on staff
- Providing support calls for the recently bereaved.
- Offering the SWAN model of care to inform the wider team on the ward that this is a sensitive time for you and your loved ones.
- Seven day service providing daily comfort reviews for patients deemed to be in last days of life.
- Provide support for Advance Care Planning conversations
- Facilitation of discharges towards the end of life, including liasing with community services
- Working closely alongside the Specialist Palliative Care team to co-ordinate support for patients, those closest to them and the staff providing care.
Our staff receive education and mentoring in the following areas:
- Recognition of patients who may be in the last year of life, and how to have compassionate conversations with them and those important to them, in order to develop a shared understanding of their goals of care, and wishes and end of life care.
- Use of Treatment Escalation Plans (TEPs) that records which treatments would be most helpful, and would, therefore, be considered if a patient becomes increasingly unwell in hospital. A TEP aims to ensure that a patient receives the best possible treatment for their individual circumstances.
- Recognition of patients who may be in the last days of life and use of the “Excellent Care in the Last Days of Life” documents to create a personalised care plan.
- Raising awareness of a London wide electronic care system called Coordinate My Care (CMC). This is a London-wide urgent care NHS service that allows personalised urgent care plans to be created and shared across organisational boundaries.