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Current services in relation to need

Adults :: End of life :: Current services in relation to need

The following services are available in Medway. These are provided by NHS, local authority and third sector providers.

Primary Care

• GPs provide generalist support for end of life patients in line with the Gold Standards Framework.
• Medway on Call Care (MedOCC) manage the End of Life Register ('My Wishes'). GPs and nurses consult, visit patients, and provide telephone advice 24/7 and direct referrals to ACAT, rapid response, community teams and specialist teams.
• The 'My Wishes Register' (Medway's End of Life Register) has now been implemented and allows patients to record electronically (via their health care worker) their wishes and advance care plans as well as their experience of the health service.

Community based care

• Marie Curie nursing, night nursing support, Crossroads, Sunflower volunteers and Social Services provide at home support for carers
• The Community Team works with the Hospice in-patient unit and the Hospital Palliative Care Team, providing general support including bereavement support to patients discharged to their preferred place of care
• A new Palliative Care helpline has been implemented to provide patients at the end of life, including their carers and family, access to 24/7 crisis support
• Cruse Bereavement care was commissioned in February 2012 to provide comprehensive bereavement support to Medway residents

Specialist Palliative Care

• Community Palliative Care Team (The Wisdom Hospice) - Community nurse specialists and care home facilitators provide assessment, symptom management, advice and support for patients with complex life-limiting illness (cancer and non-cancer), as well as their family and carers. The team also provides support to the primary healthcare team.
• Day Hospice - provides a psychosocial therapeutic environment for patients under the care of the Specialist Palliative Care team. Provides on-going assessment of the patient attending the Day Hospice, complementary therapies and provides access to other professionals as required.
• The Wisdom Hospice provides a 15 bedded in-patient care for symptom management and end of life care for patients referred by the specialist palliative care team (admission to Hospice beds currently under review), facilitate discharge to preferred place of care/preferred place of dying, with input from the community palliative care team and the family and carers support team, including welfare advisors, specialist social workers and bereavement support.

Hospital Care (Medway Foundation Trust)

• Hospital Palliative Care Team - Provide assessment, advice, symptom management to patients with palliative care needs, and support for medical and nursing teams.
• Liaise with the emergency department to prevent unnecessary admissions to wards if inappropriate to patient needs.
• An End of Life Care Matron has been employed to sustain the use of the Liverpool Care Pathway (LCP) and to improve end of life care provision throughout the hospital.

Integrated Health and Social Care teams

• Community nursing/Care Management - provide care and arrange funded care packages (help at home to meet personal care needs). Community nursing provides care to housebound patients and patients who have difficulty accessing services including end of life care.
• Working closely with the Hospice team and with all staff providing care and acting as the patient and family's advocate. Providing physical, spiritual, emotional support and symptom control for those living with a terminal illness. Care is provided to both patients and their family/carers, including post bereavement support.
• Cardiac and community respiratory services support patients in discussing end of life and symptom control.