Marie Curie Nurses to support GP practices in Derbyshire in end-of-life care pilot

Marie Curie Nurses are working closely with GP practices across Derby and Derbyshire as part of a new initiative to improve end of life care across the county.

Funded by the UK's leading end of life charity, the two-year scheme will help equip local teams with the skills and knowledge to more effectively support people with palliative and end of life care needs.

The nurses are currently based in 23 GP practices in the area, with a further eight practices set to join the scheme in the coming months. They will work with staff to improve care in a range of ways including: identifying patients in need, supporting their families and ensuring end of life care is embedded in clinical discussions.

A Marie Curie Advance Specialist Nurse will also work out of the Chesterfield Royal Hospital Emergency Department to support with the identification of people who are approaching the end of their lives and, in line with their wishes, help with discharge to a preferred place of care. It is hoped that this will help reduce avoidable hospital admissions in the last months of a patient's life.

Coreen Astle, Head of Operations for Marie Curie in the Midlands, said: "I am really excited by this fantastic new initiative. We know that when you're living with a terminal illness, getting the right clinical care and support can make all the difference.

"By placing our nurses in GP settings, we can help ensure that people at the end of life or those who need palliative care are identified and appropriate discussions take place ensuring the most supportive care can be instigated in a timely way."

Research by Derby and Derbyshire Integrated Care Board (ICB) recently found that many patients at the end of their life are not clearly identified and therefore miss out on accessing the right kind of care and support they need.

The ICB also found that some areas of the county had higher rates of hospital admission for people in the last three months of life.1

Pauline Love, End of Life Care Lead at the Derby and Derbyshire Integrated Care Board, said: "People at the end of their life are in need of the best care we can give them. They deserve to die with dignity in the best place for them. This is often at home with their loved ones and ideally not in a hospital. If we can make this happen for as many people as possible, we will achieve our goal.

"We know from our data that we need to do better for people as so many get admitted to hospital when they could be treated at home. The help and expertise of the fabulous Marie Curie nursing team in this pilot scheme mean we can pass skills onto local teams, so this work is sustainable into communities now and in the future."

End-of-life care typically includes symptom relief, palliative support for physical, emotional, and spiritual needs, personalised care planning that respects patient wishes, support for families and carers, and coordinated care from GPs, nurses, hospices, and other professionals.

Hazel McMurray, a GP from Emmett Carr Surgery, said: "It's been fantastic to be part of this pilot scheme and I'm really looking forward to the practical difference it will make to our team and ultimately the patients.

"Getting end of life care right is so important for people and their families and so anything we can do to improve patient experience will have a huge lasting impact.

"The Marie Curie nurses are amazing and by working with them and learning from them we will know we're doing the best job we can for families which really helps with staff morale and job satisfaction."

Initially the project will involve Marie Curie clinical staff embedded in Primary Care Networks, working alongside existing services to promote timely and supportive palliative care, by:

Using health data to identify the 1% of patients likely to be in their last year of life regardless of diagnosis

Supporting GP practices to facilitate decision-making conversations between the patient, their families and their health and care professionals - helping to create an understanding of what is important to the person and complete advanced care plans where appropriate

Supporting a network of teams, including GPs, District Nurses and Allied Health Professionals, to ensure end of life care discussions are embedded in multi-disciplinary team meetings

Working with Primary Care Network teams to reduce avoidable hospital admissions in the last months of a patient's life by embedding a Marie Curie Advanced Specialist Nurse in Chesterfield Royal Hospital Emergency Department

Working with Marie Curie Companion volunteers to help reduce palliative care isolation, raise awareness and sign post people to information and resources available in the local community

Basic end-of-life care training has already reached 300 health and care professionals in Derby and Derbyshire, but this new initiative will further strengthen skills within Primary Care teams.

There are plans to expand the pilot to include GP practices in East Derbyshire and South Bolsover within the coming months.

For more information about the project OR to find out more about the clinical roles available contact Coreen Astle, Head of Operations, Midlands: Coreen.Astle@mariecurie.org.uk