Policy Number: Clinical 03 Issue No: 01
Date Issued: 01/07/07
Review date: 30/06/10
People Responsible: Modern Matron
1 THE PHILOSOPHY OF CARE
The aim of St John’s Hospice is to warmly welcome people with a progressive illness, which has failed to respond to curative treatment, into the quiet calm of a highly professional, caring atmosphere which comforts always both them and those who are important to them.
LOCATION
St John’s Hospice in Wirral
Mount Road
Bebington
Wirral
CH63 6JE
| Main Telephone Number | 0151 334 2778 |
| Fax Number | 0151 334 2558 |
| info@stjohnshosice.org |
POPULATION
Adult population served by Wirral Primary Care Trust and Neston and Willaston G.P. practice populations from Western Cheshire PCT.
HOURS OF WORK
See individual services
REFERRAL CRITERIA
For patients with advanced, progressive, incurable disease - usually cancer - who have complex physical, psychological, spiritual, social or carer needs. Referral can be made by consultants, specialist registrars or general practitioners using the common referral form.
AIM
The Hospice provides services in Inpatient, Outpatient and Day Care arenas. The aim is to provide a specialist palliative care service through a multi-professional team approach. The multiprofessional team assesses and works collaboratively to enhance the physical, psychological, spiritual and social areas of peoples’ lives.
MEETINGS
Multi-professional team meetings are held in both Inpatient, Day Care and Outpatient Clinical areas.
DISCHARGE FROM SERVICE
Discharge takes place when the patient, their family and or health care professionals no longer require specialist palliative care intervention.
| ORGANISATIONAL PROFILE | ||
| Core Team | WTE | |
| • | Consultant in Palliative Medicine | 1.8 |
| • | Hospice Practitioner` | Sessional Basis (0.2) |
| • | Clinical Assistant | Sessional Basis (0.3) |
| • | Staff Grade | 0.5 |
| • | Rotational Specialist Registrar | 1 |
| • | Rotational Senior House Officer | 1 |
| • | Modern Matron | 1 |
| • | Patient Services Manager | 0.8 |
| • | Allied Professionals Team Manager | 0.4 |
| • | Inpatient Sisters | 2.0 |
| • | Sister Day Care / Outpatient | 1 |
| • | Nurses – Inpatient | 27.19 |
| • | Nurses – Day Care / Outpatient | 3.97 |
| • | Social Worker | 1.6 |
| • | Bereavement Services Co-ordinator | 0.6 |
| • | Chaplain | 0.5 |
| • | Psychologist | Vacancy |
| • | Occupational Therapist | 1 |
| • | Physiotherapist | 0.6 |
| • | Creative Therapist | 0.4 |
| • | Aromatherapist | 0.4 |
| • | Administrative Support | 3.32 |
The clinical team is supported in a variety of ways by a group of volunteers.
| 2 INPATIENT UNIT | |
| Hours of Work | The unit operates 24 hours per day, 365 days of the year. |
| Referral Criteria | For patients who require 24 hour assessment and holistic specialist palliative care; whose needs cannot be met by specialist palliative care providers elsewhere. |
| Standard | See Admission & Discharge Policy. |
| Meetings | Multi-professional team meetings are held on Monday mornings from 09:00 to 10:30 and on Thursday mornings 11:30 to 13:00. All patients are discussed and a plan devised so as to address their complex symptoms and needs. In addition a consultant ward round is carried out each Monday and Thursday when each patient is seen by a member of the medical staff, usually a consultant. |
| Discharge from Service | Patients are discharged to nursing homes, to their own or family homes, or hospital when they no longer require 24 hour specialist palliative care inpatient provision. |
| 3 OUTPATIENT SERVICE – MEDICAL CLINICS | |
| Hours of Work | Monday p.m. Tuesday p.m. Wednesday a.m. and p.m. |
| Referral Criteria | Where patients under the care of the primary health care teams require medical access to assessment and holistic intervention of specialist palliative care services. Standard Response Times Urgent referral within 10 working days Routine referral within 30 working days. |
| Discharge from Service | Discharge takes place when the patient no longer requires or wishes specialist palliative care intervention. |
| 4 DAY CARE SERVICE | |
| Hours of Work | Tuesday, Wednesday, Thursday 08:30 to 16:30 subject to (Patient attendance hours 10:00 to 15:00) flexibility to meet the needs of the service. |
| Referral Criteria | When a limited period of assessment and monitoring and care planning are required to promote improved quality of life and independence, when medical and triage nurse assessment and access to the MPT are indicated. Standard Response Time Response time will be within 7 Day Care working days from referral. |
| Meetings | Multi-professional Team meetings are held from 09:15 to 09:45. |
| Discharge from Service | Discharge takes place when the identified needs have been met or when the 12 week period of assessment has been completed. |
| 5 ALLIED PROFESSIONAL TEAM 5a AROMOTHERAPY SERVICE |
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| Referral Criteria | Referral may be made for patients within the Inpatient, Outpatient and Day Care services and relatives / carers who are assessed as potentially benefiting from the therapeutic effects of aromatherapy. Standard Response Time Within 4 working days of referral. |
| Hours of Work | Tuesday to Friday 09:00 to 13:00 There is no weekend, bank holiday or holiday cover. |
| Discharge from Service | Patients and relatives will be discharged from the service after a maximum of 3 sessions, but can be re-referred. |
| 5b BEREAVEMENT SERVICE As well as the Bereavement Services Co-ordinator the team is supplemented by a group of trained volunteers and supervisors who are allocated work in an appropriate and timely manner. |
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| Hours of Work | The Bereavement Services Co-ordinator works on Monday, Wednesday and Thursday 08:30 to 16:30. The Bereavement Volunteers may do visits outside of those hours, both during the day and in the evening. |
| Referral Criteria | People are referred for bereavement support if the deceased person has been known to the Inpatient, Outpatient or Day Care clinical areas. A bereavement risk assessment form is completed by all staff who have something to contribute to this and the work is then allocated by the Bereavement Services Co-ordinator, both to her self and to her team of trained volunteers. |
| Discharge from Service | The service can remain involved with some users for up to 13 months, if necessary i.e. past the first anniversary of the deceased persons’ death, although interventions are often for a much shorter period. |
| 5c CHAPLAINCY | |
| Referral Criteria | People may be referred by another member of the multi-professional team for religious and/or spiritual support and guidance. Standard Response Time |
| Hours of Work | The Chaplain’s time provides a service Monday to Friday, although some cover outside of those hours may be provided as required and at the Chaplain’s discretion. There is also a trained group of volunteer Chaplain Assistants who supplement the service provided by the Chaplain. Local clergy are also available to provide religious and spiritual support when deemed appropriate. |
| Discharge from Service | People are discharged from the service when the current spiritual/religious need has been met, but may be re referred by any member of the MPT as long as the person has not been discharged from the Hospice Specialist Palliative Care Service. |
| 5d CREATIVE THERAPY | |
| Referral Criteria | Patients attending the Day Unit, who want to participate in and who may benefit from creative therapy may be referred. Standard Response Time |
| Hours of Work | Tuesday to Friday 09:00 to 13:00 There is no weekend, bank holiday or holiday cover. |
| Discharge from Service | Patients are discharged from the service when they have completed a piece of work and / or when they are discharged from Day Care |
| 5e PSYCHOLOGY SERVICE The provision of this service is under review. |
| 5f PHYSIOTHERAPY SERVICE | |
| Referral Criteria | Patients may be referred who require individual physiotherapy for pain relief, functional mobility, breathlessness or the provision of specialist mobility related equipment. Standard Response Time |
| Hours of Work | Monday, Tuesday, Wednesday, Thursday – totalling 25 hours over the 4 days with flexibility to meet the needs of the service.. There is no weekend, bank holiday or holiday cover. |
| Discharge from Service | People are discharged from the Physiotherapy Service when they no longer require specialist input. They may be re-referred by any member of the MPT as long as they have not been discharged from the Hospice Specialist Palliative Care Service. |
| 5g OCCUPATIONAL THERAPY SERVICE | |
| Referral Criteria | Patients requiring assessment and assistance in managing activities of daily living in the home environment. Patients requiring assistance with anxiety management through relaxation techniques and energy conservation. Standard Response Time |
| Hours of Work | Monday to Friday 08:00 to 16:00 with flexibility to meet the needs of the service. There is no weekend, bank holiday or holiday cover. |
| Discharge from Service | People are discharged from the Occupational Therapy Service when they no longer require specialist input. They may be re-referred by any member of the MPT as long as they have not been discharged from the Hospice Specialist Palliative Care Service. |
| 5h SOCIAL WORK SERVICE | |
| Referral Criteria | Patients or their carers, both adult or children, requiring a social work service to include an assessment of social and family carer issues including welfare benefits, emotional / psychological support, liaison with external agencies in order to arrange a safe and appropriate discharge. Standard Response Time |
| Hours of Work | Monday to Friday 08:30 to 16:30 with flexibility to meet the needs of the service. There is no weekend, bank holiday or holiday cover. |
| Discharge from Service | People are discharged from the service when the current social need has been met, but may be re referred by any member of the MPT as long as the person has not been discharged from the Hospice Specialist Palliative Care Service. |
FLOW CHART TO DEMONSTRATE PROCEDURE AS REGARD DISCHARGE FROM OCCUPATIONAL THERAPY AND PHYSIO SERVICE
