Important choices - where to die when the time comes - one of the High Impact Actions
The aim: to increase the numbers of people who are able to die in the place of their choice and avoid inappropriate admission to hospitals.
Case studies
Click on the small images, above, to access the video case studies.
Community Health Oxfordshire
Community Health Oxfordshire worked with Sue Ryder, a specialist palliative organisation outside
of the NHS, to develop a shared specialist central role: the community matron for supportive and
palliative care. This role supports people with complex needs during acute episodes, with
particular focus on long-term conditions.
Important choices - where to die when the time comes, case study 1 - Community Health Oxfordshire (922.19 KB)
NHS Leeds Community Healthcare
The district nurse is the lynchpin to end of life care for patients in Leeds. This role is supported
by a flexible and responsive Complex and Palliative Continuing Care Service (CAPCCS)
providing vital support and essential care as part integrated end of life care.
Important choices - where to die when the time comes, case study 2 - NHS Leeds Community Healthcare (894.05 KB)
Solihull NHS Care Trust
Community nursing staff in Solihull are developing their end of life services to ensure that patients
who want to die at home are given every support. They are preparing care packages to provide a
seamless service for those at the end of life,focusing on supportive care and anticipatory needs.
Important choices - where to die when the time comes, case study 3 - Solihull NHS Care Trust (1.42 MB)
Literature review
The literature review was commissioned by the NHS Institute to take forward previous work in assessing the costs and benefits of high impact actions by nurses and midwives.
This literature review updates the High Impact Actions for Nurses and Midwives: Rapid Review of Economic Data conducted by Pricewaterhouse Coopers in November 2009.
This report details the findings from the literature review and will be used to inform both the case studies and economic modelling.
Literature review - Important choices - where to die when the time comes (361.89 KB)
Return on investment (ROI)
On field visits the NHS Institute team obtained a detailed understanding of the approach that has been taken by clinicians, who was involved, the impact (costs and benefits), and the data available to evidence this impact (pre and post implementation measures wherever possible).
Additional data have been secured through ongoing liaison with key informants including business managers, health informatics and audit staff. Modelling Modelling has been undertaken to generate a costs to benefits ratio.
The modelling utilises the following data:
- Data from the literature review on the scale of the problem nationally, and the associated costs of the problem (i.e. potential savings);
- Data from the literature review on impact;
- Data from the sites on impact and the costs of implementation.
The first two bullet points are used as face validity checks for the data secured through field work and to provide proxy indicators where field data are unavailable. An excel workbook of their cost benefit calculation including all underpinning assumptions is provided.
Solihull ROI Summary (300.22 KB)
Additional information
Integrated framework service framework Leeds Community Healthcare (91.59 KB)
Solihull EOLC service improvement Nov 09 (605.36 KB)
Opportunity Estimator
The opportunity estimator allows you to calculate the potential cost savings associated with making improvements in the High Impact Actions . It utilises information from the literature reviews that are available in each High Impact Actions section. The opportunity estimator will give you an indication of potential savings, if you want to carry out a more thorough Return on Investment (ROI) analysis there are tools available at www.institute.nhs.uk/roi
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See all of the submissions that were received in this category.
Contact the High Impact Actions team
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