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UK – England

Platinum Partners

Connected Palliative Care

UK: England

Sandwell and West Birmingham NHS Trust

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Platinum Partner

Services Offered

Connected Palliative Care is a service for patients and their relatives and carers in Sandwell and West Birmingham who have a life-limiting illness.
We work in partnership with other health professionals such as the GP and community nurses to support and coordinate care.
We lead quality improvement for end of life and palliative care across our care system.

SPICT Uses

We have used SPICT for many years in paper format to facilitate identification of people with palliative care needs. With new electronic systems we intend to integrate SPICT - into our systems ,SystmOne (Community notes) and Cerner (Acute EPR), to equip all our clinicians with access to evidenced based tool to start conversations, initiate palliative approach and record their reasons for doing so.

Lyndon West Bromwich West Midlands B71 4HJ

Crawley CCG

UK: England

Crawley



Platinum Partner

Services Offered

Commissioning

SPICT Uses

Primary care- GPs using this to identify which of their patients are end of life.

Horsham and Mid Sussex CCG

UK: England

Horsham

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Platinum Partner

Services Offered

SPICT Uses

Locala Community Parterships CIC

UK: England

West Yorkshire

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Platinum Partner

Services Offered

Locala Community Partnerships provides NHS community services to over 400,000 people in Kirklees, West Yorkshire and beyond. We are a Community Interest Company - an independent, not-for-profit social enterprise. Being a social enterprise means we have the freedom to improve and develop what we do. We deliver NHS services but in a much more coordinated, integrated and community-focused way. The people who are most in touch with people's needs - doctors, nurses and therapists as well as elected members of the public are directly involved in shaping as well as providing our services for patients and families. Locala works with local stakeholders; Kirklees Council, Kirkwood Hospice, Yorkshire Ambulance Service and Kirklees Clinical Commissioning Group to plan end-of-life services for the local community.

Locala provides a range of care to adults within the community through nursing, urgent care response, care home support and adult therapy. Clinicians often care for adults living with life-limiting conditions, so future planning and preparation for end-of-life care are key to providing timely, appropriate care.

SPICT Uses

The value of SPICT™ is well documented, but it is currently used by clinicians as a stand alone application on a mobile phone. Evidence that it has been used to support clinical decision-making is therefore lost within the clinical record. Becoming a Platinum SPICT Partner will enable Locala to develop a SystemOne version of the tool within the online clinical system used by the organisation. The SystemOne SPICT tool will ensure that data is recorded chronologically within a patient's clinical record.

Royal Cornwall Hospital, Treliske

UK: England

Cornwall



Platinum Partner

Services Offered

- District general hospital within Cornwall, offering services including ED, medical admissions, and outpatients.
- There are also outpatient services in oncology, and inpatient palliative care

SPICT Uses

- To identify deteriorating patients within general medicine (specifically eldercare), and planning to use it within the outpatient setting. It has yet to be trialled within the hospital, but our advanced care planning steering group would like to trial its usage within eldercare first, with an aim to then branch out into other medical specialities and surgery.

South Warwickshire University NHS Foundation Trust (SWFT)

UK: England

Warwick Hospital and Warwickshire locality



Platinum Partner

Services Offered

We are promoting SPICT with the acute and admitting medical teams at Warwick Hospital, with a prompt for SPICT within the Acute Medicine paper clerking booklet, the Specialist Palliative Care Team and the ward based nursing and medical champions are teaching their hospital colleagues about SPICT; SPICT is also being championed with community nurses, GPs and Specialist Palliative Care Teams.

SPICT is recognised in our local palliative and end of life care workstreams and collaborative working groups and SPICT being used during palliative and end of life care training programmes locally which are open to local health and social professionals.

SPICT Uses

SPICT is
• becoming further embedded across our Trust as an intrinsic tool – in the hospital and community settings
• helping staff to better recognise patients who would benefit from a supportive and palliative approach to their care
• supporting staff to think more proactively about their patients' future care needs
• prompting staff to signpost/refer patients to appropriate support services upon discharge or admission into hospital
• facilitating staff to communicate using the same language together to further improve continuity between the hospital and community settings
• providing a helpful tool for staff when considering the medical plans for patients
• encouraging staff to have appropriate conversations with patients about their future care planning and to enable them to achieve their preferred place of care.

West Suffolk Hospital NHS Foundation Trust

UK: England

Bury St Edmunds, Suffolk

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Platinum Partner

Services Offered

District general hospital with serving a population of around 280 thousand in Suffolk. Palliative care team support adult patients in all inpatient beds.
The WSH FT also provide community based services as well.

SPICT Uses

To help identify individuals with deteriorating health who may benefit from advance care planning conversations.

Yeovil District Hospital NHS Foundation Trust

UK: England

Yeovil, Somerset

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Platinum Partner

Services Offered

A District General Hospital providing a range of services specialist services including general medicine, cardiology, general surgery, orthopaedic surgery, trauma and paediatrics. Inpatient care is provided across the site with 345 inpatient beds.

SPICT Uses

One of the priorities for the Trust over the next years is to improve the identification of patients who are in need for an advance care planning discussion. We have trialled the use of the SPICT tool within teams such as the Frailty and respiratory who have found it helpful and we are keen to role this out further to assist teams and members of the MDT in this recognition.


Here are two versions of the Yeovil SPICT tool

Standard, with space for a label
Patient Record, with tick boxes against each item.

Partners

Aintree University Hospital

Liverpool

Services Offered

Aintree University Hospital NHS Foundation Trust is a large teaching hospital in North Liverpool.  We serve a population of around 330,000 in North Liverpool, South Sefton and Knowsley providing a range of acute and non-acute specialties, and work in partnership with other organisations to provide community-based services. We also offer specialist services with a world-class reputation to a population of 1.5m residents across the North West and are a Regional Centre for Oral and Maxillofacial surgery and the North Western Hepatobiliary Centre

SPICT Uses

The hospital has a Specialist Palliative Care Team who respond to referrals on the wards. We have close links with Woodlands Hospice, The Walton Centre for Neurology and Liverpool Community Health.  Together we are keen to the make Advance Care Planning Process as straight forward as possible to encourage our staff to feel knowledgeable and confident enough to have appropriate conversations with patients at the right time to enhance patient choice.

County Durham and Darlington NHS Foundation Trust

Bishop Auckland Hospital

Services Offered

CDDFT is one of the largest integrated care providers in England. 7000 staff serve a population of around 650 000 people. Our vision is Right First Time, Every Time and our values are to provide Safe, Compassionate and Joined-up Care.

The trust comprises secondary services including two acute hospitals with Accident and Emergency Departments, six community hospitals and a wide range of Community services.

SPICT Uses

SPICT is being used in the Specialist Frailty Unit in Bishop Auckland Hospital, combined with the Clinical Frailty (Rockwood) Score to identify patients at the highest risk of mortality within 3 months, in order to prioritise "What Matters Most" conversations and Advance Care Planning with our inpatients prior to discharge.

A study conducted here showed that for patients with two or more SPICT general indicators and two or more clinical indicators and a Clinical Frailty Score of 6 or more, mortality risk was 50% within 3 months. As a result we now screen all inpatients using SPICT and CFS.

We are helping many more patients to develop Advance Care Plans. When our patients are discharged with high quality ACPs, they die in their preferred place of death.

This use of SPICT is being "rolled out" within two of our other community hospitals, and the Acute Frailty Teams at our acute hospitals in Durham and Darlington.

Other information

This QIP has been submitted as an abstract for the British Geriatric Society autumn conference. It is also being included in the new National Statutory Guidance on End of Life and Palliative Care for Integrated Care Board commissioners.

Difficult Conversations

London

Services Offered

Difficult Conversations workshops provide experiential, multi-professional training to generalist NHS and social care staff on how to have compassionate conversations; covering issues such as a new diagnosis e.g. cancer or dementia, deteriorating health and dying. Training improves patient choice, professionals confidence and skills addressing difficult conversations, knowledge of key legal issues, identification of at-risk patients, and the quality of care-planning and discussions around these common themes. The training is quality assured, endorsed and a nationally scaling programme.
There are two training models:

1) Standardised ½ day workshop, delivering training to up to 20 multi-professionals, by 2 experienced trainers.
2) Train the Trainer, 2 day training for up to 6 local, multi-professionals. This offers sustainability.

SPICT Uses

SPICT is highlighted in our workshop presentation and a copy is handed to each attendee as part of their delegate pack.

Hoyland Medical Centre

Barnsley

Services Offered

Palliative care services for our registered patients.

SPICT Uses

Within our palliative care MDT

Ipswich Hospital Trust

Ipswich, United Kingdom

Services Offered

Ipswich Hospital Trust is an acute trust with a regional cancer centre

SPICT Uses

Ipswich Hospital palliative Care Team is exploring the use of the SPICT tool in education and training material throughtout the trust with the aim of improving recognition of people at risk of dying and recognition of when to offer advance care planning and additional support.

NHS Birmingham South Central CCG

Birmingham

Services Offered

In 2013, South Central Birmingham CCG, Sandwell and West Birmingham CCG, and Solihull CCG collaborated to provide training for GPs on breaking bad news (using Sage and Thyme sessions) and informing them of SPICT as an alternative  prognostication tool in addition to the GSF tool.

SPICT Uses

GPs were informed that they should register with the website if they were using the SPICT tool.

North Middlesex University Hospital

London

Services Offered

Palliative Care Team offering ACP to all patients identified as last year of life.
New ACP initiative Trust-wide to increase identification of patients suitable for ACP, based on SPICT.
ACP offer in Pall Care outpatient clinic and accepted criteria for inpatient referrals.

SPICT Uses

ACP policy refers to SPICT tool for identification of patients.
SPICT app referenced in policy and at training sessions for junior doctors and consultants, as well as in ED training programme.

Pilgrims hospices

East Kent (Canterbury, Ashford & Margate)

Services Offered

We are a hospice service providing inpatient care over 3 sites, community support for the entire East Kent health economy and input into the acute hospital trust locally(East Kent University Hospitals NHS Foundation Trust).

SPICT Uses

At Pilgrims hospices we are committed to providing fair access to all patients with needs, that are palliative and supportive irrespective of the diagnostic label of their progressive illness. Therefore we are using SPICT as an aide memoire to help triage referrals and aid discussions with referrers about their appropriateness.

We are also using SPICT to help navigate individuals through our service in helping judge prognostic awareness and in particular for non-malignant conditions to engage with advance care planning.

Royal United Hospital Trust

Bath, UK

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Services Offered

Acute hospital trust.

SPICT Uses

To assist clinicians identify the needs of elderly frail patients and patients with dementia in order to make appropriate decisions and have informed conversations with patients and families about the plan of care, their future and their end of life care needs.

Sheffield Place, South Yorkshire ICB

Sheffield

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Services Offered

Commissioning palliative and end of life care services in Sheffield

SPICT Uses

SPICT has been added to the Sheffield chronic disease review templates in primary care for COPD, Heart failure and dementia to help prompt review of decline and highlight if there is need for advanced care planning.
Teaching sessions for community staff to promote the use of SPICT to aid earlier identification of palliative patients for addition to the GP palliative care register.
There is a plan to share SPICT4All with hostel staff as a way for them to help recognise potentially palliative patients amongst the homeless community.

St Barnabas Lincolnshire Hospice

Lincolnshire UK

Services Offered

The Hospice are the lead for EPaCCS in Lincolnshire. This is a national directive and offers an opportunity to drive change in Primary and Secondary Care through clinical engagement, templates, care plans and education. We have chosen to do this as much as possible in an organisational agnostic fashion.

The Hospice runs a specialist in-patient unit in Lincoln, a hospice in the hospital in Grantham and a community hospice in Louth. We have a directorate within the main secondary care provider unit and offer support on the wards. St Barnabas also delivers day therapy, an out patients service and hospice at home across Lincolnshire.

SPICT Uses

The SPICT tool is attractive to us the emphasis is on identifying need rather than prognosis and it manages this on a single page. We have included this in our EPaCCS educational website www.eolc.co.uk and in our End of Life Brochure. These resources are for all Health and Social Care professionals. We are highlighting it to GPs when we visit or present at meetings. The consultants are discussing it throughout the secondary care trust.

St Wilfrid's Hospice

Chichester

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Services Offered

Palliative care services
Education

SPICT Uses

In education sessions

Other information

Thank you so much for your continued work on this great tool!

Sussex Community NHS Foundation Trust

Sussex

Services Offered

Sussex community NHS Foundation trust is the main provider of community NHS health and care across Sussex, providing essential medical, nursing and therapeutic care to adults, children and families.
Our expert teams provide essential medical, nursing, and therapeutic care to adults, children, and families.
Our aim across all of our services is to provide people with high quality care that is safe, effective, compassionate and offered with respect. We aim to provide a patient-centred approach allowing patient choice around the location of their care.

We provide a range of different services throughout a wide area of Sussex both out in the community and in dedicated clinical areas. In total, we have nearly 6,000 members of staff working across Brighton and Hove, East Sussex, High Weald Lewes and Havens and West Sussex.

Our staff work in multi-disciplinary teams combining a range of specialisms and backgrounds linking closely with our health and social care partners to offer integrated, seamless services to our patients.

SPICT Uses

We are using SPICT4ALL tool to assist in identifying people in the last year of their life. It is part of the End of Life Care Strategy for the Trust and is currently being rolled out across community nursing services and forms part of the patients digital record. This will enhance advance care planning at a much earlier stage to ensure robust plans are in place in a timely manner. SPICT4ALL is being embedded into our operational & clinical processes to ensure equity across our patient cohort. Its is also supported by our local ICB and is part of the ongoing ambitions across Sussex with all providers.

 University Hospitals Coventry and Warwickshire NHS Trust

A Partner SPICT tool has been used as the basis for a new electronic alert for the local clinical database. Specialists working in the fields of palliative medicine, cardiology, respiratory medicine, oncology, haematology, neurology, elderly care, nephrology and old age psychiatry have supported the development. The electronic clinical alert flags patients who are being managed with a supportive and palliative care approach.

Robust clinical governance measures ensure that only senior clinicians who have received the online training about using the Partner SPICT can upload an alert. The online learning module also provides accessible training covering some aspects of palliative and end of life care including how a new alert is communicated to the primary care team and the importance of appropriate investigations and management of such patients.

Contact:   Dr Jon Tomas 

 Doncaster and Bassetlaw NHS Foundation Trust

We are providing specialist palliative care across the health locality and are leading the implementation of our local End of Life Care plan. Locally we have agreed that we would like to use SPICT across the hospital and community to help guide identification of the last year of life.

Contact Dr Laura McTague

Rotherham Doncaster and South Humber NHS Trust St Johns Hospice

St Johns Hospice provide Specialist Palliative Care and End of Life care via a ten bed Hospice In patient Unit,Fifty place Hospice Daycare, Community Macmillan team,Hospice at Home, Living Well Information team and Counselling Team

The tool will be used to assist staff to identify and focus on patients in the last year of life to populate the newly developed EPPACS in Doncaster

Contact Mrs Helen Thompson