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Palliative Care Clinical Academic Group Outcomes Book Outcomes King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book Outcomes Palliative Care Clinical Academic Group i King’s Health Partners King’s Health Partners brings together: n three of the UK’s leading NHS Foundation Trusts n a world-leading university for health research and education n nearly 4.8 million patient contacts each year n 40,000 staff n nearly 30,000 students n a combined annual turnover of more than £3.7 billion n services provided across central and south London and beyond, including nine mental health and physical healthcare hospitals and many community sites n a comprehensive portfolio of high-quality clinical services with international recognition in cancer, diabetes, mental health, regenerative medicine, transplantation, cardiac and clinical neurosciences n a major trauma centre and two hyper-acute stroke units King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book About King’s Health Partners King’s Health Partners brings together n Bring together our partnership’s collective a world-leading university for health research strength in a range of specialist services to and education, King’s College London and three deliver world-class patient care and research NHS Foundation Trusts Guy’s and St Thomas’, through our institutes programme; King’s College Hospital and South London and Maudsley. n Developing education, research and capacity building programmes in global We are an Academic Health Sciences Centre health including partnerships with healthcare where world-class research, education and teams and organisations in Sierra Leone, clinical practice are brought together to Somaliland and Zambia. benefit our patients. We are uniquely structured to deliver our To support our mission, we are delivering mission for excellence. Our 22 Clinical Academic programmes of work to: Groups (CAGs) bring together all the clinical services and staff from the three trusts with n Join up mental and physical healthcare so the relevant academic departments of King’s that we treat the whole person, through College London. our Mind and Body Programme; n Increase the value of the care we provide, and the outcomes we achieve for our patients and service users through a Value Based Healthcare approach; 01 King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book Foreword At King’s Health Partners we are committed to The primary purpose of King’s Health Partners improving outcomes for our patients and service is to improve health and wellbeing locally users and achieving maximum value for money and globally. We must deliver this goal in in everything we do. We believe that being open a challenging economic environment with rising and transparent about the care and outcomes demand for, and costs of, healthcare. We will we deliver results in a culture of improvement only achieve sustainable health improvement across our partnership. if we strive to increase value. We define value in terms of outcomes that matter to patients, Therefore, we are publishing a series of outcomes over the full cycle of care, divided by the cost books that will help patients, service users, carers, of producing those outcomes. By publishing referring clinicians and commissioners to make outcomes books, we have more information better-informed decisions. They will also help to support us measuring the value of the our staff to drive up the quality of the care we healthcare we provide. provide. The books report key outcomes for treatments provided by our 22 Clinical Academic Our goal is to use these books to allow us Groups (CAGs). CAGs form the building blocks of to reflect on and demonstrate where we our Academic Health Sciences Centre. By bringing are driving improvement and innovation. together our clinical and academic staff across teaching, training and research, we can use their Please send comments and suggestions to us combined expertise to achieve better outcomes at [email protected]. for our patients and service users. For more information please visit our website Our books are designed for a clinical and lay at www.kingshealthpartners.org. audience and contain a summary of clinical outcomes, educational activities, research innovations and publications. They also focus on other important measures, such as staff satisfaction and wellbeing. Professor John Moxham Director of Clinical Strategy, July 2018 02 King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book Cicely Saunders International Our mission is to support a centre of research to As Cicely said so eloquently learning is the key improve the care and treatment of all patients to improvement, and the more we can learn with progressive illness and make high quality about the many complexities of palliative care palliative care available to everyone who needs the more we can do to improve care for patients it, in hospice, hospital or at home. and their families. Researchers supported by Cicely Saunders International are at the forefront Cicely Saunders International was established in of this work. Bringing in the patient’s voice can 2002 by Dame Cicely Saunders OM, DBE, FRCP only make research better and more relevant and (1918–2005), to fundraise for a purpose-built continuing to innovate is the way we can honour centre combining research, education, clinical Cicely’s legacy and take it forward into the future. care, and patient information support. The Cicely Saunders Institute opened in 2010. Today we We recognise that an ageing population and fund research, education and capacity building increasing pressures on the health service cause programmes at the institute. everyone involved to think hard about the most effective way to deliver palliative care. Ensuring Dame Cicely trained as a nurse, a medical social that the patient’s voice is heard alongside the worker and as a physician. From 1948 onwards, professional’s is central to the institute’s purpose. she was involved with the care of patients with We want to pioneer research to ensure that terminal illness, lectured widely on the subject, all people can live well, free of symptoms and wrote many articles and contributed to a great with dignity. number of books. She founded St Christopher’s Hospice in 1967 as the first research and John McGrath teaching hospice linked with clinical care, Chairman, Cicely Saunders International, pioneering the field of palliative medicine. July 2018 03 King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book Contents The value of partnership at King’s Health Partners 05 Introduction to the Palliative Care CAG 08 Our aims and ambitions 14 CAG leadership structure 18 Passionate about diversity and inclusion 19 Types of outcome measures 25 Patient-centred outcome measures 28 Clinical services 34 End-of-life care in the last days and hours of life 44 Highlights from across the CAG 46 Feedback to improve our services 49 Supporting patients, families and staff across the CAG 57 Pioneering and evaluating new models of care and interventions 62 Education and training across the CAG 71 Education and training initiatives 78 Patients and the public at the centre of everything that we do 82 Let’s talk: Transforming end-of-life care conversations 87 Research across the CAG 89 Early career research 94 Clinical academics across the CAG 97 Leading the way in best practice and service optimisation 100 Research in focus 103 04 King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book The value of partnership at King’s Health Partners King’s Health Partners aims to create a centre Integrating mental where world-class research, education and clinical practice (the ‘tripartite mission’) are and physical health brought together for the benefit of patients. The mind and body are inseparable, and We want to make sure that the lessons from mental and physical health conditions are often research are used swiftly, effectively and connected. Mental health illness can have systematically to achieve better outcomes for a significant negative impact on physical health. patients and those close to them, improve public Likewise, many people with long-term physical health and join up health and care services for health conditions and progressive illnesses suffer people with physical and mental health problems. from depression or other mental health conditions. Despite this, many health services separate care By working together in this way, integrating into physical and mental and often fail to share care across different organisations and sectors, patient information. At King’s Health Partners we we can not only improve the health of the are working to overcome these barriers by treating people we care for, but also achieve better the whole person, through our Mind & Body value for money. Programme and across all of our CAGs. Focusing on the whole person and those close to them is a core principle of palliative care. We are committed to caring for vulnerable patients 05 King’s Health Partners | Palliative Care Clinical Academic Group Outcomes Book with both physical and mental ill health in an n investing in innovative programmes such integrated manner with better, faster diagnosis as IMPARTS (Integrated Mental and Physical and treatment because we know that addressing Healthcare: Research, Training and Services), mental distress improves physical health outcomes 3DfD (3 Dimensions of care for Diabetes) and vice versa. Across all Kings Health Partners, and 3DLC (3 Dimensions of care for we will treat the whole person by: Long-term Conditions); n screening all patients with chronic physical n recognising the importance of employee diseases for mental health conditions, and mental and physical health and wellbeing. using the learning from this to improve the care we provide; Public health n improving our understanding of the physical health needs of people with severe mental Public health is one of our biggest challenges. ill health; At the root of much of the ill health in south London is a high incidence of smoking, alcohol n addressing the traditional distinctions abuse and obesity.
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