Advanced practitioner to support care home residents with palliative care needs

South West Yorkshire Partnership NHS Foundation Trust’s (SWYPFT) palliative care / end of life service have received funding from Macmillan Cancer Support for an advanced practitioner post to support palliative care patients within care homes in Barnsley. 

Katie Yockney (formerly SWYPFT end of life practice educator) will be undertaking the three year pilot role, which will focus on advance care, treatment and escalation planning for care home residents with palliative care need.

Working alongside primary care, secondary care, community services, care homes, social care and the Yorkshire Ambulance Service, Katie will ensure that robust individualised plans are in place which will inform the health and social care teams of the individual’s wishes.

Starting with the south neighbourhood, the pilot will be rolled out across all six neighbourhood localities during the three years of the project.  Katie will liaise with the GP practices within each neighbourhood in order to identify appropriate care home residents.

Care homes will then be approached and supported by Katie to develop an appropriate care plan for the individual resident based upon both their and their family’s wishes. Alongside our current teams, Katie will provide support to the care home staff through training, advice and guidance.

In order for the advanced specialist practitioner (care homes) pilot to be successful, support from the local GP practice community is needed to help identify needs and to play an active role in the joint development of care and treatment plans.

Practices may wish to use information collected via their Electronic Palliative Care Co-ordination System (EPaCCS) or the practice’s electronic frailty index or alternative practice data sources to identify appropriate care home residents.

The project will follow information governance processes to enable practices to share this information with the advanced specialist practitioner.

Project management for the pilot will be provided by SWYPFT as the hosting organisation, whilst a quarterly steering group, which has representation from Macmillan (including Steph Edgar, Macmillan GP), the CCG, primary care, secondary care, SWYPFT, Yorkshire Ambulance Service and BMBC, will monitor the pilot’s progress. 

The project will be evaluated over the 3 year period. The anticipated impact of the role and the overall pilot is to:

  • Establish a process where care home residents with palliative care need are proactively recognised and managed.
  • Increase the number of care home patients and care home staff who have coordinated and seamless robust care and treatment plans in place, which have a person’s preferences and wishes at the heart.
  • Identify a reduction in the number of care home residents who are inappropriately admitted unplanned to hospital.
  • Increase the confidence of care home staff and visiting health and social care teams when caring for care home residents.
  • Increase satisfaction levels and a feeling of improved quality of care being delivered to care home residents and their family members in relation to their palliative care.
  • Create a collaborative working arrangement with primary, secondary and social care in relation to advance and medical planning for care home residents with palliative need.

Dr Steph Edgar, Macmillan Cancer Support’s local GP facilitator, commented: “The development of the Macmillan advanced specialist practitioner role will be a great resource not only for the staff and residents of care homes, but also for the primary care team.

“Katie, with her wealth of knowledge and experience, will be able to support GPs in recognising and delivering robust palliative care planning with the right patients at the right time. 

“The training and support she can offer care home staff will be invaluable in encouraging holistic care with the wishes of the patient at the forefront. 

“I know I am certainly looking forward to working with her over the next 3 years.” 

Sue Clarke, Macmillan partnership manager, added: "We're delighted to fund this new role of Macmillan Advanced Specialist Practitioner in Barnsley.

"Katie will be using her expertise, alongside a range of professionals, to support care home residents with complex needs.

"This will include having meaningful conversations about what's important to them; ensuring the right services are brought together to create a personalised care plan."

If you have any queries or would like to get involved in the pilot, contact Katie Yockney (advanced specialist practitioner – care homes, SWYPFT) on 07775 026108.

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