Palliative and end of life care (PEOL)

What are our priorities and what do we want to achieve?

Palliative and End of Life Care Strategy

Building on the operating model and transformation plan we developed for palliative and end of life care in Lincolnshire in 2022, we have agreed our five year Palliative and End of Life Care Strategy, for adult ages, based on clinical evidence and national guidance, whilst using local intelligent sources on population data and needs to personalise care during 2024. By moving to a new model of care outlined in this strategy we will address the needs of patients, families and carers for those who would benefit from PEOL care.

This strategy takes an ambitious and transformative approach to delivery of fully integrated PEOL care to ensure accessible, equitable, sustainable, responsive, personalised PEOL care for adults, for all ethnic or social groups, areas or settings and for disadvantaged groups including those diagnosed with frailty, dementia, learning disability and severe mental illness.

Our delivery model

The delivery model to implement this strategy focuses upon five key specific but connected areas:

Enhanced Care – People, families and carers will be supported to access enhanced care including complimentary therapies, support groups, practical support in accessing housing or the benefits system and emotional and psychological support including some bereavement services provided by experienced workforce.

Core Care – Includes all health and care teams who provide direct palliative and end of life patient care.

Single Point of Access – A Single Point of Access (SpOA) for palliative care needs provides access 24/7 through a single point of contact and coordination of (planned, unplanned, specialist and in-patient) care, for adults with a palliative diagnosis, families (all ages), carers (all ages) and professionals.

Integrated Specialist Care – Includes specialist and targeted palliative care services working as a single team across organisational boundaries under an integrated specialist palliative care clinical, quality and service leadership.

Workforce – A single team, working across organisational boundaries.

What are we doing? Examples of our work

Strengthening coordination of care

During 2024/25 we have strengthened coordination of care such that planned referrals will be managed alongside unplanned referrals, through a single point of access for palliative patients. This provides access 24/7 to clinical triage for people, carers and their families and integrated with community response teams. We have designed a strategic commissioning arrangement for integrated specialist palliative care during 2024, where services will work as a single team across organisational boundaries under an integrated specialist palliative care clinical, quality and service leadership. Introduction is expected during 2025/2026. We have designed a tiered training and education package for palliative care for introduction in 2025.

We continue to support ongoing operational sitrep and Operational Pressures Escalation Levels (OPEL) reporting to the system for PEOL and review policies and Standard Operating Procedure (SOPs) through system and organisational governance.

ReSPECT (Recommended Summary Plan for Emergency Care and Treatment)

ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a national initiative, developed by the Resus Council UK. ReSPECT gives people and those important to them, a voice through the opportunity to discuss choices and wishes and develop a personalised escalation and treatment plan should they be in an emergency where they are unable to speak for themselves. In Lincolnshire we have introduced a system wide ReSPECT policy and standard operating procedure alongside audit tools and training and education resources supported by a clinical reference group.

Our work continues supported by a system clinical specialist palliative leadership group and other connected forums including ReSPECT clinical reference group, co-production group and Quality and Patient Safety Group as well as various quality improvement groups.