The King’s Fund (funded by Aetna and the Aetna Foundation) is examining co-ordinated care for people with complex chronic conditions though a series of five case studies. The project involves looking into different approaches to care co-ordination in primary care settings, in different parts of the UK. Each case study explores issues including the care planning / co-ordination process, patient stories and team working approaches.
The present case study involves the Midhurst Macmillan Service, a community-based and consultant-led specialist palliative care service based in a rural community in southern England. This service covers approximately 150,000 people in Surrey, Hampshire and West Sussex, and is funded jointly by the NHS and Macmillan Cancer Support (to a value of £1.2 million per year). In 2010/11, 409 patients used the service.
The majority of patients supported have a diagnosis of cancer, but the service supports a growing number of patients with other conditions including dementia, heart failure and neurological disorders. A multidisciplinary team of nurses, palliative care consultants, occupational therapists, physiotherapists, and volunteers works in cooperation with local care providers – general practitioners (GPs), district nurses, social services and continuing care teams – to provide care in people’s own homes. Benefits to service users include being enabled to die in a place of their choosing (instead of a hospital). The cost-effectiveness of this service, and the overall impact on patients and carers, is being reviewed.
“What appears most important to the success of the approach has been its ability to detect and provide a personalised and rapid response to meet people’s needs at an earlier phase than other models as well as to have a community-based team with the mix of skills to maintain most people effectively at home”. (p.29).
Thiel, V. Sonola, L. Goodwin, N. [and] Kodner, D.L. (2013). Midhurst Macmillan Community Specialist Palliative Care Service: delivering end-of-life care in the community. London: The King’s Fund / Aetna and the Aetna Foundation, August 2013.
[A brief reference to this item features in Dementia and Elderly Care: the Latest Evidence Newsletter (RWNHST), Volume 3 Issue 9, August 2013].