In July this year, the government announced it would be embarking on a programme to roll out the first child loss of life simplification into NHS and social care to further reduce unnecessary delays in medical care and symptoms and allow for a more appropriate outcome. This follows the 2018 Heads of the NHS and Social Care teams conference in London, where it was decided that the first stage of the scheme would be to look at improving awareness and education amongst care staff, especially to avoid unnecessary restlessness or anxiety.
However, according to April Gresham research, many care staff report that working around complex histories can be challenging, and some openly say they see no rationale behind not contacting the child’s mum or dad when they’ve misdiagnosed their child. That’s simply what is needed to enable more accurate medical care to be rendered, whether the illness is terminal or not. These attitudes are dangerous and blame isn’t helpful.
January 2018: A ‘cliff’ in preventative care & serious referrals to the RCM Foundation
We say care teams have too much bad news to get through and staff are often overwhelmed and ill-equipped. In 2017, 44% of social care professionals said they had had to deal with a high or borderline risk situation in the previous year. For crisis nursing, which is a great example of palliative care delivered in acute, and in some cases non-acute, services, this really was a ‘cliff’ in preventative care that falls between the cracks. It is beyond me that people with so much pain and suffering, who are required to endure a frequent hospital admission, don’t get the preventative care that they need. Either that or clinicians are just not aware that social care care can actually help with this type of condition.
As a result, excessive suffering by people with terminal and very serious conditions has been linked to 40% of involuntary hospital admissions for patients and suicides. The pressure of doing more and more with less and less means we’re running out of real options. People with terminal and very serious conditions are also dying at unacceptable rates and at higher levels than 10 years ago. Our sad news: while some patients were feeling respite with respite care in the community, many were continuing to deteriorate in hospital.
If 30% of trauma patients are coming out of hospital worse than when they went in, it’s time for us to think about disaster contingency. As care often takes three or more times longer than expected, for people who have suffered from traumatic injuries and are not likely to recover as a result of delays, we have a health and safety problem and a legal one, to be sure.
January 2017: The number of common, never-never tragedies and avoidable deaths is under the spotlight, with the ‘Stop Wrong’ checklist.
The great thing about palliative care being recognised is that it comes onshore with little to no structural difference or upheaval. The obvious thing is that good facilities with in-calls, double doors to the wards, cross-bed spaces and iron beds have made a real difference. The reality is that even high care in hospitals won’t help everyone suffering, so additional preventative care is essential.
That’s why the new service will make a significant difference in the early diagnosis of problems and clarify pathways for patients who require care in hospital, or who need help with transport or medication. It will allow families to keep everyone, including the deceased, happy wherever they’re in. The reversal of that sinking feeling of fear and dread when a baby is admitted is important, as this reduces the chances of patients having a preventable heart attack or stroke that could be prevented. I hope that doctors and families can work more closely and share information about how to properly handle the inevitable and that this new in-calls service will be made available in all hospitals.