The evaluation, carried out by the University of Bristol's School of Social and Community Medicine, looks at a range of services which aim to support and better coordinate care for people who want to be looked after at home at the end of their lives. The services, which launched in 2010, were developed through the Marie Curie Delivering Choice Programme (DCP), in partnership with Marie Curie Cancer Care, NHS Somerset and NHS North Somerset, local Clinical Commissioners, local hospices, acute trusts, social care and voluntary and independent sector organisations.
The study found that people receiving a Delivering Choice Programme service were 80 per cent less likely to die in hospital in Somerset compared to those who did not receive care from the Delivering Choice Programme. The study also found that emergency admissions to hospital in the last month of life were 39 per cent lower and Accident and Emergency attendances were 34 per cent lower for Delivering Choice Programme patients, compared with people not in contact with the services.
In North Somerset, Delivering Choice Programme service users were 67 per cent less likely to die in hospital; emergency admissions were 51 per cent lower; and Accident and Emergency attendances were 59 per cent lower.
The evaluation also looks at the experiences of patients, families, carers and health professionals using the services, who consistently reported excellent quality, co-ordinated care. Family carers in particular found all services with direct patient contact very beneficial, reporting that the services released them from their full time caring role and reduced their anxieties.
Dr Sarah Purdy from the University of Bristol's School of Social and Community Medicine, said: "The results of this evaluation of the Somerset Delivering Choice Programme are very encouraging. The interventions delivered produced robust results in terms of lower levels of hospital utilisation and fewer people dying in acute hospitals. However, perhaps even more impressive are the findings that family carers found the care delivered to be very well co-ordinated and of high quality."
Jan Hull, Chair of the Project’s Executive Committee, added: “All partners have been deeply committed to ensure that the new services we developed were right for patients and their families as well as being sustainable. The results from the evaluation are very positive and show that the new services are really making a difference to terminally ill patients and their families at end of life in Somerset and North Somerset.
“Although these results show a really positive impact on patients and families, there is still more that can be done especially in ensuring more people are able to access the services and benefit from them earlier”
The Delivering Choice Programme services included in the Somerset study are:
- End-of-Life Care Coordination Centres
- Out of Hours Advice and Response Line
- End of Life Care Discharge in Reach Nursing Service
- Electronic end of life care register and the recording of Key Worker
- Delivering Choice End of Life Care pathway and the Palliative Care Framework