Agenda item

To view the presentation of:

-       Programme manager, Start Well and Age Well, City and Hackney Place-based Partnership, NHS North East London;

-       Joint CEO and Director of Clinical Services, St Joseph’s Hospice; and

-       Joint Director of Operations, City and Hackney GP Confederation.

The Committee viewed a presentation delivered by the Programme Manager at Start Well and Age Well at City & Hackney Place-Based partnership, the joint CEO and Director of Clinical Services at St Joseph’s Hospice, and the Joint Director of Operations and City & Hackney GP Confederation. The presentation set out updates on current end-of-life support and impact and the Committee noted in particular the following:

•       An overview of community and inpatient Palliative and End of Life Care (PEoLC) services in the City of London;

•       A summary of the NHS North East London ICB Palliative and End of Life Care Strategy;

•       Activity and progress on End of Life Care within Primary Care in City & Hackney (with detail from the Neaman Practice);

•       Overview of the Marie Curie Overnight End of Life Care Rapid Response Service; and

•       Report from St Joseph’s Hospice covering key activity, inpatient ward re-development, work to improve links with community services, and achievements.

The Committee noted the PEoLC strategy at the NHS North East London; the 2024/25 priority on embedding activities that focus on practices’ EoL procedures at micro practice level; the Marie Curie Rapid Response Service; and the activities of St Joseph’s Hospice.

A Member congratulated the Hospice for its warmth and friendliness noted during a visit in 2023.

A Member asked for more information on the triage process for patients ending their lives in hospices. Members heard that patients tended to express a preference, and that referrals tended to come from palliative care teams. The meeting noted that many patients would be admitted a few times for symptom management. 

A Member sought further information on hospice capacity and how that related to funding sources. The meeting heard that funding came from a range of sources including grants, and that fundraising was a real challenge particularly in respect of expanding the community team and that virtual wards for palliative care were worthy of future consideration.  

A Member asked how the quality of death was judged, noting the obvious challenge in obtaining personal feedback. The meeting noted that bereaved relatives were surveyed, and that 90% of relatives had felt that patients had died in the right place (following a survey a few years ago). The meeting noted that preferred place of death was not necessarily a metric of a ‘good’ death and was, rather, a proxy measure given that end-of-life situations could change rapidly.  Members noted the role of unwanted medical interventions, and the potential for better education around the end-of-life process.