New pharmacy service is first of its kind in UK

The drive to keep the elderly out of hospital, (with the risk that they might be provided with curative treatments), continues unabated. We are told that people living in the Glasgow and Clyde area can now benefit from an innovative new service, co-ordinated from their local pharmacy – the first of its kind in the UK. It means patients and their carers will have improved access to the medications for end-of-life care - (those which assist the `dying process`, or should we call it a journey? - even for those with `life limiting` conditions who are not actually dying.)

It will ... support patients, should they choose to die peacefully at home rather than spending their final days in hospital.

Yes I`m sure it will. It will also support carers who make decisions on behalf of their patients. This is the care plan for which ten new Macmillan pharmacy facilitators will be working with existing community pharmacies.

http://www.nhsggc.org.uk/content/default.asp?page=s1192_3&newsid=17420&back=home

The OptCare study

A number of people in Sussex have been invited to take part in what is called a research project to test a new palliative care service for frail older people living at home or in a care home. 900 people who registered the death of a relative, friend or cared for person are being contacted to give their views on a questionnaire. The purpose is to be able to analyse why some people received care which met their needs and preferences, while others did not.

Your views are very important and will greatly help to provide better care for patients and families in Sussex and across the United Kingdom in the future.

Can this possibly be true? The important thing to notice is that the needs and preferences of the 900 dead people are being requested from third parties, some of them with conflicts of interest regarding any assessment of the dead person`s care or preferences.
http://www.csi.kcl.ac.uk/files/Link%20to%20patient%20information%20sheet.pdf

So what drives this kind of nonsense research which no doubt will find in favour of keeping the elderly out of hospitals with `Do not resuscitate notices`?

 

 

The demographics of an aging population is, again, the core concern and driver. The UK’s ageing population has “considerable consequences” for public services as is discussed in UK Parliament –

The pensioner population is expected to rise despite the increase in the women’s state pension age to 65 between 2010 and 2020 and the increase for both men and women from 65 to 68 between 2024 and 2046. In 2008 there were 3.2 people of working age for every person of pensionable age. This ratio is projected to fall to 2.8 by 2033.

 http://liverpool-care-pathway-a-national-sc.blogspot.co.uk/2014/01/liverpool-care-pathway-trials-and.html

Monklands nurse helps to improve the care of patients with dementia

A Monklands nurse is helping to improve the care of patients with dementia, after graduating as part of a recent cohort of dementia champions.

Alison Tedford (centre) is pictured with Sandra Shafii AHP Consultant in Dementia (left) and Maureen Taggart, Alzheimer Scotland Dementia Nurse Consultant (right) Senior charge nurse Alison Tedford, who works in an orthopaedic trauma ward at Monklands Hospital, completed the National Dementia Champions programme and is now helping to support improvements to the care provided in acute hospitals across Lanarkshire.

 

We are told in the article that one in four patients occupying a bed in hospital is over 65 - well, that is to be expected. What is extraordinary is the claim being made that this same group of patients have the symptoms of dementia or a diagnosis of dementia. I believe that figure is an over-estimation and deliberately alarmist.

Alison has been expertly trained by the University of the West of Scotland and Alzheimer’s Scotland.

 

This probably accounts for the fact that dementia is being over-estimated. Alzheimer`s Scotland also put forward the notion that dementia is a life limiting illness [progressing slowly, my emphasis] and one in three people who died had dementia. This does not mean that the people died of dementia and Alzheimer`s Scotland are misleading the public. But if you want to introduce palliative care to this group of patients it would help to build this kind of confusion.

Alison said:  “Dementia Champions provide specialist advice to staff on patients who have a diagnosis of Dementia or have cognitive impairment. They can provide support in relation to assessment of needs in relation to eating and drinking, the patient’s environment and indentifying whether the patient is in pain.

It`s a disgrace that it has had to come to this. Surely nursing staff should already know that all patients need to eat and drink and might require assistance, and pain relief is not just for the dying. 

http://www.nhslanarkshire.org.uk/news/news/Pages/Monklandsnursehelpstoimprovethecareofpatientswithdementia.aspx

Paul Gray visits Greenhills, East Kilbride

Paul Gray, new head of NHS Scotland, visited Greenhills East Kilbride where he met the care team looking after people in their homes and so reducing hospital admissions.

 

You have to ask yourself, why is he smiling about downsizing the care of the elderly? My 95 year old father was put out of hospital in October 2013 and has seen his carer twice in the past three months. Both times she flew in for a few minutes to deliver his medical aids before flying out again. Home care is actually the minimum of care. 

Successful end of life care extended ?

Not good news for patients with heart conditions. The Liverpool Care Pathway was first developed for cancer patients and to begin with it was considered inappropriate to apply the procedures to patients with other kinds of health problems. Although the Liverpool Care Pathway is being `phased out`, palliative care and other similar pathways are still firmly on the agenda and the net is widening to include more patients.

If we remember that palliative care involves `Do not resuscitate notices`, no antibiotics or other treatments, no food or water, syringe drivers, a chat with the family and ultimate death the language used below is astounding. Why should this be called helping heart patients? Why should the project be called a fantastic example? How can dead patients show they appreciate anything? Isn`t the use of hyperbole actually covering up what is really going on?

A unique partnership between Marie Curie Cancer Care, British Heart Foundation (BHF) Scotland and NHS Greater Glasgow & Clyde has been extended after helping more than 230 patients in the advanced stages of heart failure. 

"Caring Together is a fantastic example of what can be done to improve end of life care for those patients with more complex care requirements."

The Caring Together programme, which aims to improve the quality and access to palliative care for any patients in the advanced stages of heart failure, is set to continue for a further 18 months.

Since launching in March 2011, the programme has helped more than 230 patients and their families and has been key in allowing these patients to stay in their preferred place of care and avoid hospital admissions where possible.

Every patient referred to the programme receives a comprehensive assessment of their palliative care needs, a review of their cardiological management, and the allocation of a care manager who coordinates and manages the care for these patients.

The programme makes sure that heart failure patients with supportive care needs have access to advice, support and services, including benefits and hospice day services, at an appropriate time in the progression and deterioration of their illness.

Marjory Burns, Director of BHF Scotland, added: "Caring Together is an innovative programme for patients with advanced heart failure that supports the Scottish Government's action plan for palliative care services, Living and Dying Well, which calls for a more equitable provision of end of life care services for patients with any advanced, progressive or incurable condition across all care settings. This partnership is showing the way in terms of a service that patients and their families really appreciate."

http://www.ehospice.com/uk/en-gb/home.aspx

The Francis Inquiry

Government provided financial incentives so that hospitals would put patients on the Liverpool Care Pathway and this happened at the Mid-Staffordshire NHS Foundation Trust too which has been accused now of substandard care. HERE  The discusssion following the inquiry below fails to mention the Liverpool Care Pathway which has also been the subject of another inquiry. It hardly inspires confidence for it was the misuse of the LCP which caused most of the problems.

CLICK HERE FOR THE DISCUSSION

 

The following is the announcement of a conference to be held in regard to the safeguarding of elderly patients. Obviously when they say things like: "We must get it right," they know they have been getting it wrong. So much talk,  conference after conference, and so little action.

Implementing the new statutory framework for Adult Safeguarding under the Care Bill

Wednesday 12 March, Hallam Conference Centre,. London

"We must get care right for the most vulnerable group, who are often the most challenging to treat: frail older people. The challenge is to embed the experience of this group in hospital care – getting it right for them is our first benchmark." 

Many of the instances of substandard care at Mid-Staffordshire NHS Foundation Trust took place in medical wards caring for our most vulnerable patients: frail older people with complex comorbidities. Achieving "gold standard" care for this group must be the priority. 

The Health Secretary has announced he is seeking views on a set of proposals to radically improve care for vulnerable older people. Safeguarding vulnerable older people is a key element within this improvement programme and is critical following the recent events at Mid Staffordshire and the recommendations from the Francis Inquiry. 

http://www.healthcareconferencesuk.co.uk/safeguarding-vulnerable-older-adults

NHS Lanarkshire Palliative Care Strategy

Here`s a nice example of carespeak/doublespeak:

NHS Lanarkshire (2012) made palliative care one of its four strategic priorities for A Healthier Future.

What kind of future does a patient have who is being provided with palliative care, when this is end-of-life care? The rest of the document outlining their strategy for palliative care is depressingly full of the same management spin.

What it amounts to is encouraging practitioners to have those `senstivie` conversations with patients and family about preferred place of dying (home/care-home). Document and share the anticipated responses after they have had those `sensitive conversations`. (Wasn`t our fault - it was their choice) Assist the target population to remain in their home/care-home. Avoid hospital admissions, emergency and curative treatments and REDUCE COSTS.

http://www.nhslanarkshire.org.uk/boards/2013-board-papers/Documents/August/Palliative-Care-Strategy-2013--August-2013-Board.pdf

Please note that hospitals are not always safe places for the elderly, but where is?

Care not killing

Care not Killing Scotland rejects the proposed assisted suicide bill recently launched in the Scottish Parliament by Margo Macdonald MSP. They are hopeful that the bill will be rejected as was her previous attempt.

http://www.carenotkilling.org.uk/news/scottish-bill-launched/

I say we do not need to legislate to allow 16 year olds to have the right to assist in the suicide of their grandparents or great-grandparents. We do not need the medical profession to be turned into `killers` and we do not need the trust that has been established between doctors and their patients over hundreds of years to be smashed by this selfish bill.

Anybody who wants to commit suicide is free to do so. That is their choice. Just do not involve the rest of us in a slippery slope to Bedlam.