End of Life Conversations

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Summary of report content

Stockport CCG and Stockport NHS FT contacted Healthwatch Stockport to ask them to take part in a review around end of life care plans to facilitate the views of local people who may have had experience of palliative and end of life care. Healthwatch Stockport devised an End of Life conversation and promoted it via social media, circulating and displaying posters via their contacts and directly contacting local voluntary organisations and community groups to invite people who have experience of end of life care. A total of 25 people contributed to the conversation. 17 people attended the event, a small number of people were unable to attend the event and so feedback was gathered electronically. They also attended a group of carers for people with learning disabilities. Overall the conversation was engaging and participants identified issues of concern which mainly included the following:- • There appears to be an uncoordinated approach to palliative and end of life care by professionals i.e. General Practitioners, District Nurses and employed carers. • Professionals often do not begin or include the initial end of life care conversation with the patient and/or carer • Carers and family members often feel that they are not listened to in relation to patient care • Patients ‘holistic needs’ are not being met as Care Plans are not developed soon enough and are not patient centred • People need more support during and after their bereavement to help address isolation, financial issues and wellbeing • There is a real concern for the care of patients who are deaf and have learning disabilities (also in circumstances if their carer dies) • Social Workers (and those employed as part of the Respite Team) are seen to be providing a good service, when they are knowledgeable and experienced • The care setting is important as the quality of care provided differs depending on the setting This report demonstrates clearly that the current model of practice for palliative and end of life care is not fully suitable to meet the needs of patients and carers in Stockport. Whilst there are pockets of really good examples of practice, this is not consistent throughout Stockport. 1. Develop a professional co-ordinator role to have contact with patients and carers and help to co-ordinate appropriate support services 2. Utilise and invest in the skills and expertise of the voluntary and community sector to help with above coordination, respite and support 3. GP’s to be provided with information on support services for palliative and end of life care 4. Improve provision for profoundly deaf people and people with learning difficulties to ensure new model meets their needs 5. Undertake further engagement with people from black and minority groups 6. Mandatory training for care staff and other professionals involved in palliative and end of life care should include information on all support services that is available to those being affected, when and how to start end of life care conversations with patients (carers and family), especially if a patient is suffering from Dementia 7. identify End of Life Care Champions to facilitate conversations in local group to keep the conversation going. Incorporate good practice from local organisations as well as national charities and organisations such as Hospice UK and the collaboration ‘Dying Matters’, The National End of Life Care Programme and The National End of Life Intelligence Network.

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General details

Report title 
End of Life Conversations
Local Healthwatch 
Healthwatch Stockport
Date of publication 
Sunday, 31 March, 2019
Date evidence capture began 
Tuesday, 29 January, 2019
Date evidence capture finished 
Tuesday, 29 January, 2019
Type of report 
Report
Key themes 
Communication between staff and patients
Continuity of care
Holistic support
Information providing
Quality of care
Service delivery organisation and staffing
Healthwatch reference number 
Rep-4927

Methodology and approach

Was the work undertaken at the request of another organisation? 
Yes
What type of organisation requested the work 
CCG
Primary research method used 
Engagement event
How was the information collected? 
Engagement Event
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
GP practice
Health visitor
Secondary care services 
End of life care
Social care services 
Adult social care
Home care / domiciliary care
Hospice services
Hospice services at home
Community services 
Community healthcare and nursing services

Details about conditions and diseases

What type of pregnancy or maternity themes are included in the report 
N/A

Details of people who shared their views

Number of people who shared their views 
25
Age group 
All people 18 and over
Gender 
All
Ethnicity 
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Yes
Does the information include staff's views? 
No
Does the information include other people's views? 
No
What was the main sentiment of the people who shared their views? 
Mixed

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.