REMEDY : BNSSG referral pathways

End of Life Care

Checked: 07-12-2017 by hana.cavill Next Review: 07-12-2018

Prognostic Indicator

The GSF Prognostic Indicator Guidance, supported by the RCGP, aims to help clinician’s in the earlier recognition of patients who are nearing the end of life and identifying the specific needs of the patient.

End of Life Checklist and EPaCCS

See the EOLC checklist for GPs. You may also find the Carers Checklist for End of Life Support useful.

BNSSG CCGs have developed a Palliative Care Co-ordination System (EPaCCS) template for use with patients on EOLC pathway and/or have DNACPR recorded. This is now embedded in EMISweb and will allow sharing of information with Connecting Care. This will replace the Adastra EOL register from 22nd February 2018. A list of EPaCCS FAQs is available.

Anticipatory Prescribing Form

See the Community Palliative Care Drug Chart. which includes a guide on parenteral medication to use at end of life.

Useful Links

Macmillan produce useful booklets for patients such as End of Life and Bereavement and Your Life and your choices: Plan Ahead. These are available to order or download from Macmillian.

In conjunction with Macmillan, Marie Curie has produced booklets for both people in the final stages of life and their carers.

Do Not Attempt Resuscitation

DNACPR forms can be ordered from the provider below:

LG Davis
46 Warstock Road
Kings Heath
Birmingham
B14 4TS

Tel: 0121 430 9000
Fax: 0121 430 9019

E-mail: Samantha.Bryan@lgdsolutions.com

End of Life Co-ordination Centre - South Glos

This service provides an End of Life Co-ordination Centre, supporting adults over 18 who have a life limiting illness and are registered with a South Gloucestershire GP and who are in the last few weeks or days of life.

The Centre acts as a link between professionals, carers and service users, ensuring that timely packages of care are arranged and meet the needs of the service user, carer and families.

Care may be provided from the following services:

  • Domiciliary care agencies

  • Palliative Care Home Support (PCHS)

  • Marie Curie Support Workers

  • St Peter’s Hospice at Home Service

These services offer specially trained support workers that work with people as they near the end of their life. The staff may work in pairs or by themselves depending on the service and the person’s needs.

These staff are used to working in a person’s home and providing physical and emotional support to both the service user and carer. The length of their visits, frequency and how long the service is provided for will depend on the service user’s needs.

In addition, care may also be provided by domiciliary care support workers. These care workers may be involved initially and work closely with service users and their families on a regular basis. As a person’s needs increase, it may be more appropriate for specially trained support workers in end of life care to become involved.

The Co-ordination Centre can also access overnight care for people at home (Night Sitters). This may be used to give carers a break for a night or two, for example. This can often help carers to continue to support their loved one at home.

The End of Life Co-ordination Centre will also act as a link between professionals, service users and families. For example, this may consist of ringing service users or carers to let them know what care has been arranged, to check if the right amount of care is being provided or assisting in providing equipment to support the person and carer.

St Peter's Hospice - Bristol

St Peter's Hospice provides end of life care for adults with life-limiting illness in Bristol.

Patients can be referred by their GP, district nurse or the hospital palliative care team.

Referral criteria and forms can be found on the St Peter's Hospice website

There are also clinical guidelines and a 24 hour specialist advice line (0117 915 9430)