Archived decisions
HAMPSHIRE PRIMARY CARE TRUST
CARE AT END OF LIFE IMPLEMENTATION PLN
11 APRIL 2007
1. INTRODUCTION
1.1. The following implementation plan has been drafted in response to the recommendations set out in the Hampshire County Council [HHC] Health Overview and Scrutiny Committee [HOSC]: Review of Care at the End of Life Report, January 2007.
1.2. The Implementation Plan has not yet been formally approved by the Professional Executive Committee or the PCT's Care Services Board. This approval process will take place on 12 April 2007 (for the Care Services Board) and later in April 2007 for the Clinical PEC.
1.3. It was originally anticipated that this plan would be drawn up in far closer collaboration with Hampshire County Council adult and children's services. Unfortunately, the transitional arrangements that the PCT is currently managing (with senior staff only just now being appointed) has delayed this joint working. However, to provide the OSC with reassurance, one of the outcomes of a meeting between the top teams of the Council and the PCT was the re-energisation of collaborative strategic working and this project will undoubtedly benefit from this commitment.
1.4. The Plan has been structured in the following way: each recommendation and associated; action, deadline and lead responsibility has been taken directly from the HHC HOSC Report. The shaded boxes provide the PCT's initial comments on the HHC HOSC Report and a high Level Implementation Plan. For completeness all local recommendations have been included, even those where the PCT is not the lead responder. in these cases implementation plans have not been developed, but comments have been provided.
1.5. As can be seen from the Implementation Plan, Director leadership of this project will now rest with Yvonne Le Brun (Area Director of Care Services), with operational leadership provided by Elizabeth Emms (Head of Adult Services - South East).
CO-ORDINATION OF CARE |
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Cross Reference HCC HSOC Report - 4.2.5 | ||||||
HCC HOSC Recommendations |
Action |
Deadline |
Lead Responsibility | |||
1 |
Hampshire PCT and Hampshire County Council shall agree a lead co-ordinator for CaEoL services across the County of appropriate seniority to effectively influence service delivery across Hampshire and begin to develop a single unified model of care. This person shall work collaboratively and in partnership with the private and third sectors to progress the recommendations made in this report and shall be identified as soon as possible. |
· An initial response shall be provided to the HOSC. · Include a draft timetable for implementation of the recommendations included in this report. |
March 2007 March 2007 |
PCT CEO/HCC CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
a b c d e f g h |
Establishment of `formal' Project Initial response provided below on each recommendation Completed PCT Lead Director identified. Completed Sign-off of proposed Implementation Plan required. In Progress Monitoring mechanism for Implementation Plan need to be agreed. In Progress Identify PCT Project Manager for this project. Completed Establish Project Steering Group (including commissioning representation) In Progress Establish Area Leads in each of the PCT's geographical areas. Completed (Heads of Adult Services appointed) Establish Care at End of Life Service Delivery Group. This will draw representation from clinical champions (including local GPs, medics, senior nursing and therapy staff), service carers and advocates, the voluntary sector and social care. Not yet started Development of Unified Model of Care Once established the Delivery Group will work through a number of actions:
· By geographical area identify [audit] the current models of care and current levels of service delivery, · Draft and agree principles for this patient group, · Ensure the current patient pathway [mapped across acute, community, social and the third sector] are understood, · Clarify the service delivery models by locality, · Establish the gaps in this provision based upon service providers input, · Establish the gaps in this provision based on users [carers] feedback, · Develop a unified care model, building on the work of the HOSC review · Reassess the gaps in service provision based on new model, · Development of a users' pathway to help direct users, carers and providers through the services. Status: Not yet started |
· Implementation Plan provided below. · Yvonne le Brun · PEC & Care Services Board · Via regular reports to PEC, to the Board (through the Board Performance & Assurance Report) and HOSC · Elizabeth Emms · Currently exploring the establishment of a joint project group with Hampshire County Council. · Given the differences in service delivery at a local level, these leads will develop services locally as well as acting as part of the Delivery Group. · Working Group Terms of Reference and membership approved by PEC · Establish Project Plan · Progress Report to HOSC/PEC/Care Services Board (note it is not anticipated that the totality of this work will be completed until the autumn of 2007) |
March 2007 March 2007 April 2007 April 2007 April 2007 April 2007 April 2007 May 2007 June 2007 July 2007 |
Lead Director PCT CEO Lead Director Lead Director Lead Director Project Manager Lead Director Lead Director/PEC Chair Project Manager Project Manager | ||
Cross Reference to HCC HSCO Report - 4.2.6 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
2 |
Organisational arrangements shall be put in place to ensure that the agreed lead co-ordinator has the authority to commit resources to identify need and agree commissioning arrangements to secure maximum benefit for patients and their families through the co-ordination of care. This shall include an assessment of the current spend on end of life care in Hampshire across all areas of care provision, including those services provided through the voluntary/independent sector. |
· An initial response for taking this work forward shall be provided to the HOSC. |
July 2007 |
PCT CEO/HCC CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT has estimated the current spend on this patient group, but there are difficulties with the robustness of this information, for example; differential accounting practice across seven predecessor PCTs; some palliative care is contained within the acute `block contracts'. In addition the incompleteness of activity recording in a community setting mean it is difficult in some cases to disaggregate community nursing spend. Additional work is required within the PCT to further disaggregate spending [if possible] and within the acute sector, to more accurately estimate the current spending level. In the midterm the commissioning arrangements need to reflect the identified needs [and service gaps] of the users/carers which will be obtained from the planned audit and survey [recommendations 4.2.19, 4.2.20]. Adopting this approach should ensure the resources available are directed at the priorities of the users [and carers] of the service. In the short-term if the PCT's gaps analysis of the current service highlights areas of concern these will be considered by the Project Team as possible areas for investment, clearly this is dependent on available funding. Status: Response required July 2007 |
· Identification of PCT current spending Levels · Further comments & plan · Commissioning Plan for this patient group |
July 2007 July 2007 Timescale dependent on audit and survey |
Project Manager Lead Director PCT Lead Commissioner for this patient group | |||
Cross Reference to HCC HSCO Report - 4.2.7 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
3 |
Proposals for agreeing the most effective way forward with regard to the potential for joint management arrangements, pooling budgets, sharing training, developing the workforce and constructively managing the tensions caused by conflicting organisational pressures shall be agreed and included in the remit of the lead co-ordinator. |
· An initial response for taking this work forward shall be provided to the HOSC. |
July 2007 |
PCT CEO/HCC CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
One of the PCT's key principles [vision] for End of Life Care is that users of these services are provided with `seamless care' appropriate to the needs of the patient, family and carers. An early win; such as providing a `road map' highlighting services available and key contacts would demonstrate a joint approach. Similarly establishing joint posts of `co-ordinators of care' would also facilitate a common approach. The process of developing the Model of Care and Service Delivery should highlight areas where further joint working is possible. Once the Model of Care and Service Delivery has been agreed, Workforce and Training plans will be developed to support the Model. Status: Response required July 2007 |
· Further comments & plan |
July 2007 |
Lead Director | |||
Cross Reference to HCC HSCO Report - 4.2.8 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
4 |
The Lead co-ordinator for CaEoL for Hampshire shall consider the work by Macmillan Cancer Support (the `Care Miles' Initiative) and the emerging lessons from the Marie Curie `Lincolnshire' Project when assessing the most effective way to ensure that CaEoL can be co-ordinated across the County. |
· An initial response for taking this work forward shall be provided to the HOSC. |
July 2007 |
Lead Director | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
`Good practice' and innovative schemes will be incorporated into the work undertaken by the Care at End of Life Service Delivery Group. Status: Response required July 2007 |
· Further comments & plan |
July 2007 |
Lead Director | |||
Cross Reference to HCC HSCO Report - 4.2.9 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
5 |
The Lead Co-ordinator for CaEoL will take early action with the local NHS and Adult Services to address the variation in service delivery across Hampshire and support front line staff by agreeing the range of services to patients and carers to be provided through the statutory sector. |
· An initial response shall be provided to the HOSC. |
July 2007 |
Lead Director | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT recognises that, in part, the care delivered to this patient group is not consistent across the PCT's 'new' geographical area. Also the means of delivery of care varies, as an example; the access to support services from organisations such as Marie Curie depends on previous arrangements, and thus the care provided by the NHS sector varies. In the short/mid term, whilst there is still a variation in non-statutory provider support, there will be a variation in the NHS services. The PCT's focus is on ensuring appropriate care is provided for this patient group, that may mean that, what is provided directly by the NHS provider arm will vary, but the level of service accessible to this patient group needs to be the same. The PCT plans to progress this work by developing a single consistent Model of Care, thus clarifying what services exist [and are appropriate] for this group, developing a service level standard, and by geographical area conduct a gap analysis verses this service level standard. This work will then inform commissioning plans for this patient group. Status: Response required by July 2007 |
· Further comments & plan |
July 2007 |
Lead Director | |||
ASSESSMENT AND INDIVIDUAL CARE PLANNING | ||||
Cross Reference to HCC HSCO Report - 4.2.10 | ||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |
6 |
Hampshire PCT and Hampshire Adult Services, working with the private and third sectors as appropriate, shall agree how a single synchronised assessment process, as set out in the NSF Framework for Older People, can be progressed. This shall build on existing good practice already in place in hospice and specialist palliative care services and include · Agreement on a consistent county wide approach to continuing care assessment that is responsive to the needs of dying patient and their carers. · Explicit arrangements through which patients that are assessed as being in the last weeks of life can access both health and social care according to need. These shall be clearly communicated to all front line staff. · Arrangements for communicating the needs and wishes of dying patients across the teams providing care · Arrangements for ensuring that other needs for advice and support to patients and their families are identified and responded to. |
· Progress with this recommendation shall be jointly reported to the HOSC. |
September 2007 |
PCT CEO/HCC CEO |
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |
The PCT supports this recommendation. Further discussion is required to agree how this recommendation is taken forward. Status: Progress Report required July 2007 |
· Progress Report |
July 2007 |
Lead Director | |
DAY TO DAY CARE AND COMMUNICATION | ||||||
Cross Reference to HCC HSCO Report - 4.2.11 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
7 |
Hampshire PCT shall review the pattern of community/district nursing/allied health professional cover available across the County to ensure that it is consistent and accessible to people requiring care in their own homes or other community settings 24 hours a day, 7 days a week. This shall include identification of lead individuals for co-ordinating care in local settings and confirmation of the support to be provided to nursing homes of community/district nursing/allied health professional cover available across the County to ensure that it is consistent and accessible to people requiring care in their own homes or other community settings 24 hours a day, 7 days a week. This shall include identification of lead individuals for co-ordinating care in local settings and confirmation of the support to be provided to nursing homes |
· The arrangements and time frame for conducting this review shall be reported to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT recognises that at times there is not consistent 24/7 cover, in some areas this has been due to the inability to obtain staff to cover, whilst others reported that communication issues with OOH services has led to lack of support. The PCT [see `establishment of the project' implementation plan - 1g] will establish leads for each of its three geographical areas. The PCT sees this recommendation as a high priority, once leads have been established, an audit by their geographical area will be conducted highlighting when and why 24/7 cover was not available to this patient group. This audit will be used to inform the CaEoL Service Delivery Group and reported through the PEC (and HOSC). The Area based audit will also review how services are accessed out of hours. Status: On-Going |
· Establish scope of audit · Audit · Report back to PEC/HOSC |
May 2007 June - August 2007 September 2007 |
Project Manager CaEoL Area Leads Lead Director | |||
Cross Reference to HCC HSCO Report - 4.2.12 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
8 |
Hampshire PCT, working with all other care providers, shall ensure that information about the services and support available to people who are in the last year or months of life is readily accessible in appropriate formats to formal carers, informal carers and patients. |
· The PCT shall report how it intends to take this work forward to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
As the PCT has only recently formed from seven predecessor organisations, the information currently available is varied in both form and format. In the mid-term, the work on the Model of Care and Patient Pathway will go on to pick up the information requirements across the pathway. Some of the `good practice' models, particularly those linked to hospice care, have good examples of information. Via the Service Delivery Group, as part of mapping out our current services, the PCT will develop an [interim] `service directory' for this patient group. The appointment of the PCT Communications and Publications Manager will support this process.
Status: Plans to be developed further once Project Manager in place. |
· Incorporate in plan for Delivery group · Audit of current information available · Draft Interim Service Directory · Interim Service Directory [CaEoL] |
May 2007 June 2007 August 2007 September 2007 |
Project Manager Communications and Publications Manager Communications and Publications Manager Communications and Publications Manager | |||
ACCESS TO CARE AND SYMPTOM MANAGEMENT | ||||||
Cross Reference to HCC HSCO Report - 4.2.13 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
9 |
Current access to specialist equipment is not acceptable and this issue needs to be addressed as a matter of urgency. Hampshire County Council and Hampshire PCT shall agree a way forward to ensure that there is appropriate funding and availability of equipment from the County Council and NHS in order to meet patient's needs in a timely, appropriate and cost effective manner. |
· HCC CEO shall report progress with this work to the HOSC. |
March 2007 |
HCC CEO/PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT considers this to be a high priority. Arrangements are close to final resolution to progress the development of improved arrangements for the funding and provision of equipment for the residents of Hampshire. Status: HCC is to report back in March 2007. |
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Cross Reference to HCC HSCO Report - 4.2.14 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
10 |
Timely communication and sharing of information across all care providers, both formal and informal shall be addressed as a key part of the roll-out of a Hampshire wide approach to out of hours care. Learning from work already underway with the Ambulance Service in south west Hampshire shall inform this to ensure that patients' needs and preferences for care are met. |
· The PCT shall report how it intends to take this work forward to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT is currently scoping the work undertaken in the South West, to establish the strengths of the system and how this is best rolled out county wide. The Service Delivery Group will reflect on this scoping work and ensure that it is embedded in the new service arrangements. Status: Report back to HOSC and PEC in July 2007 |
· The PCT shall report to the PEC and HOSC on progress. |
July 2007 |
Project Manager | |||
Cross Reference to HCC HSCO Report - 4.2.15 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
11 |
Arrangements for accessing appropriate pharmacy support (including controlled drugs) both in and out of hours shall be reviewed to identify and implement good practice to ensure that the needs of patients in their homes or other community settings are responded to in a timely and appropriate manner. |
· The PCT shall report how it intends to take this work forward to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
Although, the PCT supports this recommendation and wholly agrees that access to appropriate pharmacy support particularly in controlling pain for this patient group is essential. The perception of our service staff was that this issue was not a common challenge experienced across Hampshire. Given the number of recommendations within this report, the PCT suggests that as part of the audit of current services this area be included, with the support of the Heads of Medicines Management for the PCT, thus allowing the PCT to evaluate where there are gaps in this service. Status: Incorporate into Service Delivery Group Plan. |
· Incorporate audit as part of Service Delivery Group Plan |
May 2007 |
Project Manager/Heads of Medicines Management | |||
Cross Reference to HCC HSCO Report - 4.2.16 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
12 |
Access to specialist palliative care advice and support shall be identified across all areas and effectively communicated to formal and informal carers, including those providing OOH services. |
· The PCT shall report how it intends to take this work forward to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
This recommendation will be picked up as part of the Patient Pathway mapping by the Service Delivery Group. This group should be able to highlight potential gaps in access, but it would be better informed by the results of the users/carers audit/survey. Status: Incorporate into Service Delivery Group Plan.
|
· Incorporate into Patient Pathway mapping exercise · Identify potential gaps in service from audit of carers · User/Carer Audit/Survey · Feed into Commissioning Strategy for this patient group |
May 2007 July 2007 The timescale for further work is dependent on when the audit/survey occurs. |
Project Manager Service Delivery Group HCC Commissioning Lead for this patient group | |||
SPECIALIST PALLIATIVE CARE AND CHOICE IN PLACE OF DYING | ||||||
Cross Reference to HCC HSCO Report - 4.2.17 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
13 |
Hampshire PCT shall review the needs for specialist palliative care across all care settings to ensure that an appropriate level of service is commissioned and resourced to support people living in their own homes or the community and reduce avoidable admission to hospital. Best practice in hospice services and other partnership working across Hampshire shall inform this work. |
· The PCT shall report how it intends to progress this review to the HOSC. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
This recommendation is linked to that above [4.2.16], although the PCT will develop a Commissioning Strategy for this patient group focusing on `best practice' as stated in the previous comment, it would be better informed by the results of the audit/survey. In the short term the PCT is keen to continue to audit avoidable admissions for this patient group, it has been working with other Trusts to reduce such occurrences. The PCT considers this element of this recommendation to be a high priority. This action will be given as a specific objective to the CaEoL Area Lead. Status: See 12 above. |
See actions above in 12 · Define as a specific objective for CaEoL Area Leads |
May 2007 |
Lead Director | |||
Cross Reference to HCC HSCO Report - 4.2.18 | ||||||
HCC HSOC Recommendations |
Action |
Deadline |
Lead Responsibility | |||
14 |
Hampshire PCT, working with South Central Ambulance, Adult Services, hospice services, Care Homes and OOH services as appropriate shall ensure clear protocols are in place to respond to patients requiring transfer who may be in the final stage of their illness. This shall include specific protocols to ensure that there is clarity about the resuscitation status of the patients and to avoid inappropriate interventions or admission to hospital. Mechanisms to communicate these protocols to GPs and other front line staff shall be identified. |
· The PCT shall report how it intends to take this work forward. |
March 2007 |
PCT CEO | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
This recommendation will be picked up as part of the Patient Pathway mapping by the Service Delivery Group. Initial drafting of the Patient Pathway will be shared more widely to highlight areas of interface and to commence discussion on development of protocols etc. Status: Incorporate into Service Delivery Group Plan. |
· Incorporate into Patient Pathway mapping exercise. |
June 2007 |
Project Manager | |||
Cross Reference to HCC HSCO Report - 4.2.19 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
15 |
The comparative audit of patients admitted from nursing homes to hospital at the end of their life planned by the SHA shall take account of the appropriateness of admission and the wishes of the patient. Additionally consideration shall be given to extending this audit to include patients admitted through the OOH and emergency services. |
· Action for SHA, the SHA shall report back how it intends to take this work forward to the HOSC. |
March 2007 |
SHA Lead | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT fully supports this audit and would look to using the outcomes to aid the PCT's gap analysis and support its commissioning plans for this care group. The PCT considers this recommendation to be a high priority as it would support a `needs based' allocation of resources. Status: SHA action |
· SHA developing plans. |
SHA Lead | ||||
Cross Reference to HCC HSCO Report - 4.2.20 | ||||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |||
16 |
Hampshire HOSC, working with Southampton University, shall identify the costs associated with obtaining feedback from patients and carers about CaEoL services. |
· Progress with this work will be reported to the HOSC. |
March 2007 |
HCC CEO/HOSC Chairman | ||
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |||
The PCT fully supports this approach and it would look to using the outcomes to aid the PCT's gap analysis and support it commissioning plans for this care group. The PCT considers this recommendation to be a high priority as it would support the allocation of restricted resources. As such it has provided funding to HOSC to support this programme. Status: HCC action |
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SUPPORT TO CARERS | ||||
Cross Reference to HCC HSCO Report - 4.2.21 | ||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |
17 |
The Director of Adult Services shall provide information on the way in which informal carers' assessments are requested, who conducts these and any timescales that support this process as well as the means by which the client's satisfaction is evaluated (linked with Recommendation at 4.2.10). |
· This information shall be provided to the HOSC. |
March 2007 |
Director of Adult Services |
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |
The PCT will support this work in any way it can. Status: HCC action |
· HCC action |
March 2007 |
HCC Lead | |
Cross Reference to HCC HSCO Report - 4.2.22 | ||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |
18 |
In order to promote consistency in service provision, and support front line staff, Hampshire County Council shall publish a County wide policy setting out the support to be provided to informal carers. This shall include arrangements for supporting patients and carers with social care needs where NHS continuing care is being provided (linked with Recommendation 6 at 4.2.10). |
· The arrangements and timeframes for developing this policy shall be provided to the HOSC. |
May 2007 |
HCC CEO |
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |
The PCT supports this recommendation. Status: HCC action |
||||
Cross Reference to HCC HSCO Report - 4.2.23 | ||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |
19 |
Hampshire PCT, in liaison with Hampshire County Council, shall provide the HOSC with additional information about the support available to informal carers including: · Access to psychological and spiritual support · The range of respite provision through the NHS and County Council and how this is accessed · The lead professional for responding to informal carers' needs |
· The PCT shall report how it intends to take this work forward to the HOSC. |
July 2007 |
PCT CEO/HCC CEO |
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |
This recommendation will be picked by as part of the audit of current services. Status: PCT action required by July 2007 |
· Further response and plan. |
July 2007 |
Lead Director | |
WORKFORCE AND TRAINING | ||||
Cross Reference to HCC HSCO Report - 4.2.24 | ||||
HCC HSCO Recommendations |
Action |
Deadline |
Lead Responsibility | |
20 |
Hampshire PCT, working with Hampshire County Council and other providers of CaEoL, shall confirm funding and arrangements for the continued roll-out of the GSF, LCP and other training programmes that support the delivery of general and specialist end of life care. |
· The PCT shall report how it intends to take this work forward to the HOSC. |
March 2007 |
PCT CEO/HCC CEO |
Comments/Status |
Implementation Plan |
Deadline |
Lead Responsibility | |
The PCT, in collaboration with partner organisations, will undertake a scoping exercise to establish the scope and quality of current CaEoL related training currently provided. Through the Service Delivery Group, it will then seek to develop a training plan (with identified sources of funding). |
· Scoping exercise completed June 2007 · Training Plan developed - Autumn 2007. |
July 2007 |
Director of Human Resources | |