Palliative and End-of-Life Care by Integration Authorities: advice note

Delivery and Planning Partners

The statutory guidance states that ‘those involved in the strategic commissioning process need to develop their skills in working with a range of partners including the independent and third sector, along with service users and their carers to build and implement commissioning priorities’. In the context of palliative care, those partners may come from all the settings set out below, though care homes and particularly care at home services together with community nursing and other community based services, are recognised as playing a very significant role in enabling people to stay in their homes and communities, and this community focus is only set to increase.

Extension of Community Health Outcomes and Highland Hospice

ECHO is a tool and approach for mentoring (or 'tele-mentoring’) as well as building a mutually supportive community which has been used by Highland Hospice. They have found it vital for supporting community palliative care in which there are many lone workers faced with often extremely challenging situations.

The methodology developed by the ECHO project, over the 12 years since its inception in New Mexico, is being applied across the world in a wide variety of health care specialties. ECHO has been pioneered in the UK by Prof. Max Watson and the Northern Ireland Hospice ^[15] . The Hospice now administers and facilitates 29 different ECHO groups of which palliative care makes up only a small proportion.

Highland Hospice currently run three ECHO groups for Macmillan Cancer and Palliative Care Nurse Specialists, Care Homes and Out of Hours Emergency and Unscheduled Care Practitioners with a fourth for Community Pharmacists about to start. They have plans for groups for GPs with responsibility for care homes or community hospitals and Community Nurses.