Looking to achieve the best outcomes for end of life care in north east Essex
There is a famous quote (attributed to a number of different sources, although most probably Einstein):
“If you always do what you’ve always done, you’ll always get what you’ve always got.” And it makes a lot of sense.
The problem in business is that is can be very hard to break the cycle, to take the time to stand back and evaluate where you are at, to see what you’ve ‘got’, but this is exactly what St Helena Hospice, with the help of Oxford Centre for Triple Value Healthcare (3V), has been able to do.
Palliative and end of life care is what St Helena does and they do it really well. For over 35 years they have been providing this quality care to the people of north east Essex. The introduction of the My Care Choices Register (MCCR) back in 2013 provided the organisation with a layer of information that they previously could only guess at; the MCCR enabled those in the last year of life to record their choices for care. Where they wanted to be at the end of the life and who they wanted to have with them.
What this information showed, was that most people did not want to die in hospital; given the choice they would rather stay in their usual place of residence. This is not a surprise, but it was the data that St Helena needed to start their evaluation.
The Accounting for Value report, that was finalised and launched this summer, took the evidence from the MCCR and looked at how the money was spent locally on end of life care. The key findings were that although hospital is the least favoured choice for people at the end of their life, the majority of the end of life budget is spent on hospital care. The report also showed that, patients registered with a GP surgery that was proactively using the MCCR, had a much better chance of dying in their preferred place of care.
So how does this information enable St Helena to ‘get’ something different?
Since 2018, in north east Essex (NEE), partners have been working together as part of the North East Essex Health & Wellbeing Alliance; the Alliance follows the Live Well model and one of the domain areas is ‘die well’. As part of the ‘die well’ domain, which is co-ordinated by St Helena, an End of Life Board was created. The intention is that this Board will be given responsibility for how money is allocated for end of life within NEE. This will hopefully ensure that by doing something differently, it is the local people who will get a better outcome.
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