What is being done?

The specialist palliative care service at Salisbury General Hospital is integrated with all aspects of hospital care, including inpatient beds, the community team, the hospital team, day care, bereavement and education. Referrals are accepted for patients with non-malignant disease as well as cancer. It incorporates a dedicated specialist nurse supporting patients in nursing homes and specific education programme for End of Life Care in Dementia.

What is new and different?

There are many different models of service organisation in Specialist Palliative Care largely because the majority of the funding comes from the independent sector. The Salisbury model is not unique, but it also is not a standard model. The Specialist Nursing role in nursing homes, able to cross the divide between primary and secondary care, and incorporating education and a caseload, is a new development for our service as is the education programme for End of Life Care in Dementia.

What difference this seems to be making

• The integrated model enables the same team to care for patients in different settings. This has many benefits for patient care.
• The Nurse Specialist post for nursing homes has increased support for patients in their usual place of residence. There is audit evidence demonstrating that fewer patients have been admitted to the acute hospital at the end of their lives since the post holder has been in post.

Plans for taking the project forward

Increasing support for patients in the community particularly

• Developing a Hospice at Home service
• Extending nursing home support to all care homes