End of Life Services in Brent

The provision of end of life services for adult (aged 18 and over) GP-registered population of the North of the Borough of Brent and Harrow, who by virtue of the operation of guidance in respect of identification of the responsible commissioner are the responsibility of NWL CCG (part of Brent & Harrow Borough cluster). This includes residents from adjoining boroughs registered with Brent GPs (within a two mile radius). However, the "Hospice at Home" service is available to all Brent registered/resident patients. The Provider will provide Specialist Palliative Care to patients with progressive, incurable disease for whom death is foreseeable. The majority of patients will have cancer, but appropriate care will be offered to patients with all end-stage conditions, such as those with Motor Neurone Disease, Heart Failure and COPD. Where possible, care will be provided for people in their own homes. The service will provide: Inpatient Unit - 12 x bedded unit for specialist respite care, symptom control, and terminal care for those patients who cannot be supported in the community; there are non-medical prescribers on the inpatient unit; A Day Hospice Centre - provides day hospice services that delivers personalised outcome-based care plans for patients based on their individual needs. The centre will provide medical and clinical consultation and care, access to a Multidisciplinary Team, a range of complementary therapies, arts activities, exercise sessions for groups and information resources in a safe and supportive space; Hospice at Home - for respite care, transitional care and terminal care. The service provides specialist support by using trained Healthcare Assistants to deliver up to 14 day packages of care in community settings; Outpatients Service; Specialist Palliative Care Community Service for Brent North - provides specialist palliative care assessment of patient and family and provides expert symptom control and terminal care, incorporating psychosocial support and access to statutory financial support. The multidisciplinary team works closely with other members of Brent primary healthcare team offering direction and guidance for the management of symptoms and acts as a point of liaison and facilitation between palliative care services, primary and secondary care and the patient and family; there are non-medical prescribers within the community team.

The service will provide access to Specialist Nursing and Medical Support, Physiotherapy, Complementary Therapies, spiritual support and the Social Work and Bereavement Team, all of which occurs internally within the service. Referrals for Occupational therapy, Dietetics and Speech and Language therapy will be made to the appropriate provider. The Provider will refer patients to NHS Brent & Harrow Borough cluster Continuing Health Care Team for assessment and provision of on-going care, when the patient no longer requires Specialist Palliative Care.

The service will ensure a philosophy of ensuring a holistic approach to treatment and care allowing patients to take control of their lives and learn to manage their illnesses. Patients from all religious and ethnic groups are welcomed and every effort made to meet their individual requirements. All services provided under this contract will be provided to patients free of charge.

Early referral of the patient following diagnosis of a progressive, non-curable illness is encouraged and patients have access to the range of services the Provider offers at all stages of their illness. The needs and choice of the patient and those close to them indicate what services are required and in what setting, if those services are available. Additional information: This 12-month interim contract will allow the newly established NHS North West London CCG to continue the discussions for consistent commissioning and contracting on the following areas (this is dependent on the findings of the NWL ICS Review of all EoL/SPC services in NW London):

• Contractual framework for commissioning at NWL ICS level
• Finance and staffing resources aligned and consistent with greater demand for Health Inequalities - determine and agree how resources will be allocated
• Models of Care - agree consistent and standardised NWL ICS-wide delivery model to ensure effectiveness, efficiencies and excellent pt. experience across all levels of service delivery whilst meeting local Brent Borough population health & care needs
• Reporting - agree consistent reporting principles and processes taking into account NWL ICS and Brent ICP levels of good governance and robust assurance processes.
• Key Performance Indicators (KPIs) and Outcome Measures (OM) - review current KPIs and outcome measures to see if they are still fit for purpose and are capturing the right information needed for performance monitoring and reflective of the outcomes being measured impacting patient care.