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Marie Curie

Transforming Your Palliative & End of Life Care Programme (2013 -2015)

Palliative Care in Partnership (2016)

The Transforming Your Palliative & End of Life Care Programme (TYPEOLC) was a two year partnership (to Dec 2015) between Marie Curie and HSCB/PHA which aimed to improve palliative and end of life care services across Northern Ireland to enable equitable access to quality palliative care support for people in their own homes as they approach the end of their lives.

The programme worked collaboratively with a range of stakeholders from the five HSC Trusts, NIAS, the local hospice providers, nursing homes and domiciliary care sector, voluntary and community sector and patients and carers. Through a series of stakeholder workshops the key issues were identified and participants were asked for their ideas of how to overcome the issues. The ideas generated were reviewed and assessed against key criteria which resulted in eight workstreams being progressed. A design group made up of relevant stakeholders was established for each design group and each developed models to address the area of concern.

The programme assisted the Health and Social Care system to recognise where the issues and gaps were with regards to providing quality palliative care and to understand the differences in the support available dependent on the person’s diagnosis, location and care setting. The TYPEOLC Programme delivered a number of products and initiatives to help identify and support people with palliative care needs and to upskill the professionals to be better equipped to support these patients in their own homes.

At the end of 2015, the contribution that the TYPEOLC Programme had played in galvanising the key stakeholders together was recognised and Marie Curie committed to funding another year. Moving forward Marie Curie will be working collaboratively with HSCB/PHA to support the ‘Regional Palliative Care Programme – Palliative Care in Partnership’ with the aim assisting local partners and organisations to provide quality palliative care across Northern Ireland.

Rapid Response

The Marie Curie Rapid Response Service (RRS) provides patients and carers with flexible access to palliative nursing care across three of the five Trusts in Northern Ireland (Northern, Southern, and Western Trust areas) between 10pm and 7am (Southern) and 8am (Northern and Western). This service is also available during the hours of 8am to 10pm at weekends and on bank holidays. The Marie Curie OOHRR service in Northern Ireland is delivered in partnership with the GP Out of Hours (OOH) service where the Marie Curie Nurse is co-located.  Findings from a  recent evaluation are below:

Nurses were asked to log their perception of the outcome of each visit or call. The most common outcome reported was that of reassurance to the family and reduced anxiety about the patients’ condition/symptoms/situation. One in four visits resulted in the prevention of a crisis situation and 1 in 8 visits would have resulted in an admission to hospital had the visit not been possible. Looking at the two together, it is likely that around 28% of visits prevented a situation whereby an admission to hospital or an ambulance call out would have been likely.
From a patient perspective[1], around 52% of patients had a visit from a nurse who considered to either directly avoid an admission to hospital or prevent a crisis situation where that may have been likely. Feedback from patients and their families corroborates this finding as 50% responded that if the service had not been available they would have phoned for an ambulance and a further 9% said they would have gone directly to A and E.

  • 95% of respondents felt patients were less anxious knowing they could call the service 
  • 92% of respondents felt family or carers felt less anxious knowing they could call the service
  • 100% of respondents felt they received the support they needed
  • 100% of respondents felt the nurses made the patient feel more comfortable

Calculations show that the service is potentially resulting in at least £220,000 a year of avoided cost. The report sets out two estimates:

  • An estimated cost avoidance based on hospital avoided admissions, shows a potential saving of £543,799 per year to the trusts (not accounting for other community costs incurred from keeping patients out of hospital).
  • Estimating cost avoidance based on the Nuffield Trust study, suggests that the service is likely to have avoided a cost of around £227,007 to the Trusts. This estimate accounts for some extra community provision.

[1] Based on feedback from 44 patient feedback forms (completed by the patient and/or a family member/carer)