Compassionate Communities - From frailty to community resilience – making a public health approach to end of life care a reality

Abstract

Foyle Hospice and the Western Integrated Care Partnership recognised the need to adopt a more strategic approach to palliative and end of life care to ensure sustainability of provision and ‘reach’ of care to patients and families facing this stage of life. They proposed a Compassionate Communities pilot project funded by the local commissioning group. Using a public health approach itrecognises that communities have the skills, knowledge, expertise and a role to play in end of life care. The project aims to build capacity within communities to support those living with advanced illness and frailty and their families and carers, to reduce social isolation and to enable people to remain living at home and connected to their communities. At its heart is a network of trained Compassionate Neighbours who provide weekly contact to people who have become isolated as a result of illness. Modern palliative care has been criticised with some arguing that it has led to the development of a model of care which relies heavily on medical expertise and sits within a framework more aligned with curative outcomes that are not achievable in palliative or end of life patients. The pilot programme comprised of three key aspects: 1. Awareness raising using a whole population approach. 2. A model of care which recognises that end of life care is a social as well as a medical issue and seeks to expand the model of health care to include communities as genuine partners – not simply as targets of service provision. 3. Community engagement (via Conference; Café conversations; Follow up/ Education events). 4. Key stakeholders are two communities in the Waterside area of Derry/Londonderry, their GP practices, associated health and social care professionals, Foyle Hospice and the Integrated Care Partnership of the Local Commissioning Group. The duration of the pilot project is August 2015 to March 2017 The highlights in terms of innovation, impact and outcomes are listed below: 48 volunteers trained 66 referrals received 54 home assessments 28 matches/ relationships 19 referrals in progress Referral pathways and trust established between Health and Social Care professionals and the Community and Voluntary Sector Local and regional health forums Meetings with local council resulting in a motion that the council would work to become a “Compassionate City” Citywide conference One Day – an art exhibition Presentations and workshop at ICP Conference and Hospice UK Conference Short film produced by local students The project will be independently evaluated in terms of the health and well-being of volunteers, people and carers and the impact on the reduction in the need for primary health care services. In terms of sustainability and transferability the aims are: To build links with interested groups to develop models and resources which allow greater involvement in the care and support of those who are approaching the end of life at home. To identify current networks of support and encourage joint working. To develop a model that can be replicated/adapted