Midhurst Macmillan community specialist palliative care service delivering end-of-life care in the community

Abstract

The Midhurst Macmillan Service is a community-based, consultant-led, specialist palliative care service in a rural community, which serves some 150,000 people across Surrey, Hampshire and West Sussex. The service was set up in 2006 in response to the sudden closure of a local hospital with a Macmillan Cancer Support palliative care unit. It has since evolved to provide end-of-life services to local people at home. and to prevent avoidable admisisons to hospital . It is jointly funded by the NHS and Macmillan Cancer Support to a total value of £1.2 million per year. This report describes a model of care that is co-ordinated across a range of partners including GPs, district and community nurses and social workers, complemented by 70 volunteers who fulfil a variety of roles. The report includes story case studies indicating the difference that the service has made in administering pain relief and providing practical and emotional support at the end of life. Among key lessons and distinctive points of this service are: awareness raising and relationship building; holistic care assessment and personalised care planning; referrals from any health professional; and rapid access to care from a multidisciplinary team. This study is part of a research project undertaken by The King’s Fund and funded by Aetna and the Aetna Foundation in the United States, to compare five successful UK-based models of care co-ordination.