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Cancer and Palliative Care Update

Cancer and Palliative Care Update. Advance Care Planning Gold Standards Framework (GSF) in Crae (Nursing) Homes Feedback from Bedford Cancer Local Implementation Group (LIG) Significant Events. Advance Care Planning. Expression of preferences

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Cancer and Palliative Care Update

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  1. Cancer and Palliative Care Update • Advance Care Planning • Gold Standards Framework (GSF) in Crae (Nursing) Homes • Feedback from Bedford Cancer Local Implementation Group (LIG) • Significant Events

  2. Advance Care Planning Expression of preferences • And is not a legally binding directive nor set in stone • Why? • How? • When? • Where? • Communicating and sharing ACP

  3. Initiating conversation about future care One suggestion ‘So that we can look after you as well as you would like us to, it would be really helpful to know if you have any thoughts about your future care. Is there anything that you would or would not like to happen?’

  4. GSF in Care (Nursing) Homes Project for Bedfordshire • Financed by End of Life money • 2 year programme with GSF central team • ‘Taster’ on 2nd October • Year 1 workshops every 3 months attended by nursing home ‘champions’ • Year 2 ‘embedding’ with continued facilitation by local and central GSF team • Accreditation

  5. GSF in Nursing Homes • Nurse-led but some GP input and support • Register (all patients but prioritised) • Regular meetings to discuss patients • Advance Care Planning • Communication with OOH’s • Pre-emptive prescribing • Liverpool Care Pathway • After Death Analysis (ADA)

  6. Why GSF in Nursing Homes? • 20% of deaths in nursing home • Current GSF is practice-based and excludes nursing home patients • Shown to reduce - hospital admissions by 12% - hospital deaths from 18.2% to 10.6%

  7. Bedford Cancer LIG • Skin cancer • Communication • Mortality Data • Hospital Multidisciplinary Meetings (MDT’s)

  8. Skin Cancer • Dr Burova • NICE guidance (attached) • Any doctor involved in treating cancers (including solar keratoses and Bowen’s disease by cryotherapy) should attend MDT’s at hospital every 3months

  9. Hospital/GP communication • Results of Hospital MDT meetings • ?how useful • Outpatient letters • 10 working day SLA • ?acceptable

  10. Mortality Data • Lack of transfer of information re date and cause of death between Hospital and GP’s and vice versa • Audit of Deaths • One point of contact at hospital • ?Service level agreement • Death administration protocol example

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