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County palliative care line heading towards 24-hour service

A phone service which helps people facing life-limiting illnesses will soon be operating a 24-hour service after a rise in demand.
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NHS 111- palliative care line to go 24-hours soon

NHS 111, option three - palliative care - is a phone service which launched in April 2021 to help those with the illness, their carers, and health professionals access the support they need, when they need it.

Since it was launched across Cambridgeshire and Peterborough, the service has responded to 1,692 calls within a 38-week period.- up until the end of December 2021. 

The line, currently for adults only, is a community-based service and is staffed by clinical nurse specialists. The idea of the service is to improve access to advice, support and care and liaise with carers and relatives and health professionals across primary and secondary care. 

Since it began, the operating hours have changed following data. During weekdays, it runs from early mornings, about 7am until lunch time. And resumes back from 5pm to midnight. Weekend and bank holiday they run a 24-hour service. 

The team presented the latest updates on the service during the Healthwatch Cambridgeshire and Peterborough meeting on Thursday (January 27). 

End of Life Care Programme Manager Clare Moody said:" We had 1,014 contacts through hubs. That's different patients totalling 1692 calls. 

"We generated another 2,153 calls by taking the cases on, speaking to district nurses, speaking to GPs, different professionals to help solve problems."

The phone lines cover both Cambridgeshire and Peterborough, but the majority of calls have come from Peterborough and Huntingdon, followed by Cambridge. 

And it was revealed, they are seeing more patients with no hospice links coming through for support.

According to figures, 55% that used the phone lines were not known to Palliative care services. These are people with life-limited illness and that’s how many were not known to either of the two hospices the services works with - Sue Ryder Thorpe Hall or Arthur Rank Hospice in Cambridge. 

Who can call the hub? 

Any adult registered with a GP in Cambridgeshire and Peterborough who is living with, or supporting someone with a life-limiting illness, can use the service which is free and available by calling 111 and selecting option 3.

Most of the calls, over 1000 of them, have come from a carer or relatives of the patient.

The team said: "We also work very closely with East of England Ambulance Service, working together on joint decision making – whether to take them to hospital or not, having conversations with patients, what their wishes are, etc 

"We are seeing an increase in nursing and care homes contacting us- which is great as it's another group of people we are trying to support. "

In terms of diagnosis,  44.5% of the patients supported by this service were cancer patients. But the service is open for other non-malignant life-limiting conditions and 31.5% of patients were non-cancer patients including those with dementia (17%), heart problems (17%), chronic respiratory diseases (15%) and stroke (8%) among other issues. 23% had both cancer and other health issues. 

The main reason for the calls is symptom management or emotional support or hospice referral - where people are experiencing sudden sudden pain (97%), or are agitated (41%), or experiencing breathlessness (36%). 

The team said: "The beauty of the line is when people call, we take over. We liaise with GPs and professionals so that the person can be with the patient. We communicate with hospital, GP or district nurse, take on those calls to sort out the situation, and then call back the patient and update them, 

“We can let them know for example if there’s a prescription to collect from out-of-hours or to expect a call back from a doctor. We take it on for them and almost take the burden off them (family or carers). 

“Since it has been running, we have managed 148 avoidable admissions. If there is a need we do take them to hospital. But these were avoidable instances. 

“The service hasn’t been promoted massively since it began due to some staffing issues but are now hoping to offer a 24-hour service all through very soon.” 

The service has won a national innovation award recently for the innovation in care it has been offering.

The team shared examples on how they have supported patients and their families:

“For example- a teenager called because their parents’ syringe pump was alarming. There was some fault and she was able to call the service using video technology and we worked out what was wrong and helped put it right. 

“We have calmed situations with people with dementia diagnosis going through agitating times. We have calmed those situations and prevented hospital admissions. 

“We have people who call us for assurance if they have shortness of breath, if they live alone, they call for support. 

“If we didn’t take these calls, then they would be going into the larger 111 service, so we are trying to take these burdens off. "

Does the service get any inappropriate calls? 

“We have thought carefully about the option three. Some people don’t understand the palliative care option. We have received a lot of suicidal calls recently who would press any button, so we do our best to support them but try and get them to mental health crisis line. 

"It has decreased a lot, but we know if 111 is busy then we have people trying to contact someone.” 

You can find out more about it here