Palliative care teamBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i1991 (Published 08 April 2016) Cite this as: BMJ 2016;353:i1991
- Nigel Hawkes, freelance journalist
- London, UK
Harrow end of life single point access
For people in their last year of life, fragmentation of care is a burden they can do without. “When we looked at care for this group, we found no continuity, nobody to take responsibility, and nobody to turn to in a crisis, particularly at the weekend,” says Nicola Davies, end of life lead for Harrow clinical commissioning group (CCG) in north west London.
The answer was to set up a single point of access—a telephone number available 24 hours a day and seven days a week for patients, carers, and healthcare professionals. Operated by St Luke’s Hospice, the number can be used to summon a rapid response team between 7 am and 11 pm for any patient registered for more than a year with a Harrow GP and identified as being in the last 12 months of life.
As well as providing a better service, the new system reduces hospital admissions and increases the proportion of patients able to die at home to almost 90%. “Nationally, in their last year of life people are admitted to hospital an average of three times,” Davies says. “If we could reduce that to two, we could save £1m a year. I hope we can do that—we’ve had a good start.” The service cost £246 000 (€305 000; …