Listening into Action gave our team a ‘can do’ attitude as well as improving end of life care

A specialist Palliative Care team based in South Lakes have used the Listening into Action approach to make some very valuable changes to improve end of life care.

The team of 8 Clinical Nurse Specialists provide a vital end of life service to patients within their own homes. An important part of their role involves providing medication to help with symptom control so that patients are more comfortable in the last days and weeks of their lives.

Symptom control frequently involves medication changes, and the team were finding that the process involved in making these changes was unsafe, difficult, time consuming and causing unacceptable delays for patients and their families. Contacting a GP to request changes could often take up to 6 calls, made even more difficult in rural areas with patchy phone signals! Prescriptions had to be hand written and there were complexities in getting issued prescriptions to patients. Something had to change…..

Jenny Wilson, a member of the team decided to qualify as a non-medical prescriber (NMP) so she could prescribe medicines and speed up the process. However, when she did qualify she was dismayed to find that even with these new skills, there were practical hurdles she could not overcome.

Jenny decided to use LiA to get all the right people together to work through the issues and make the process better for patients and their carers. A multidisciplinary LiA sponsor group was formed with staff from pharmacy services, a GP surgery, the palliative care team, an EMIS application specialist and was supported by the chief nurse. Together they worked on the issues and made changes. Initial outcomes from pilot work have been very positive:

  • There is now a same day prescription service resulting in faster symptom control for patients
  • Prescriptions can now be printed by NMP qualified nurses in the team, significantly reducing the chance of error and time spent hand writing prescriptions
  • Time spent contacting GP surgeries and pharmacies has been greatly reduced, helping the team with workload

Jenny reflects on the outcomes; “I felt that LiA unlocked doors that we could not have unlocked ourselves. The key to making it work was that we were put in touch with the right people in the right department and that those people knew to prioritise the work because LiA had the backing of the senior management. I found the whole process very inspiring actually, it created an enthusiasm in the team that wasn’t there before and it really has made a massive difference to patient care. Before the team were very frustrated and quite despondent, now they are thinking of more ideas to help make things better. The whole process has given us a renewed ‘can do’ attitude”