Consultation Hub

As Neighbourhood Clinical Commissioner, Steve Bradshaw has indicated an interest and wish to be involved in the development of social prescribing networks. 

TPA Community Connectors arrange periodic 'Team around the Place' meetings.  These offer the opportunity for local groups/residents to meet and share their values along with what their group can offer as a means of promoting greater local knowledge.

An example of a positive outcome was that at the Marple meeting it was noticed that there was a clash of meeting times between two groups both of whom would have benefited the same group of attendees.  Therefore one group agreed to change their meeting times.

The overall outcome of all meetings is a better local  knowledge between groups of what is already available and potential gaps.  This will hopefully also then lead to ongoing cooperation and signposting between groups.

Overall aim of the engagement

The aim of the engagement was to learn from experiences of family carers what works well, what needs improvement, what is missing and what suggestions people might have to improve our local palliative care offer.

What we were asking

• What support did you use and how useful was it for you & person you cared for?
        Prompt: support can be professionals, services, information such as leaflets etc.
• What did you find challenging / gave you extra stress?
  Prompt: can be transport, I.T, lack of information, communication ect
• What did you miss / what didn’t work well / what can we do better?
• Were your needs assessed / what are your needs at the moment and what support do you receive / need?

What participants said

Strengths:

• End of life team at home
• End of Life assessment
• Enhanced care team highly valued but only in last 2 weeks of life
• Advanced care planning works especially well for dementia patients but not necessarily for other conditions

Weaknesses

• Not a person-centred care plan, no choice provided
• Not possible to book respite care
• Variable support from GPs: some very supportive GPs and some carers reported not having received much support from their GP
• Lack of conversations to discuss and plan end of life care
• No bereavement support offered
• Lack of training for staff; staff don’t know when / how to start conversations and what services are available
• Treatment for pain was lacking

Challenges

• Adapting home gave stress and had an impact financially; home environment felt less homely
• Need to start conversations earlier
• Skills of family carers not appreciated by care home staff when cared for moves into care home
• Support for deaf people in end phase of life was lacking

Barriers

• Disjointed services
• Lack of training for family carers

What we did or will do as a result (ie how this will influence decision-making)

The feedback from the participants confirmed that the new model needs to have:

• A single contact point for patients and family
• More opportunities for respite for the carer
• Right balance between peer support for carers based on condition and more generic; to create more opportunities to meet others in a similar situation for carers looking after someone with a less common condition
• Clearer signposting on bereavement support offer
• Continuity in contact with carers by services in days after person passed away to avoid abrupt ending of support on day person passed away

Based on the feedback we have now

• Made a split between the palliative care and bereavement pathway to acknowledge the different needs
• reviewed respite opportunities and are looking in creating more options for respite
• looked at continuity in support for carers in first days after death
• improved joint working between elements of the pathway
• extended enhanced support team involvement
• looked at training opportunities to upskills staff e.g. home care staff

Colleagues were asked about challenges they faced day to day when dealing with clients.

TPA colleagues asked for training on a list of commonly encountered difficulties relating to clients mental health

To help improve competencies of non health staff in managing distressed patients within a social prescribing setting, a series of training sessions covering the list was developed and delivered in a small group interactive setting.