System Response to Reducing Admissions in the Last 90 Days of Life
As part of an ongoing commissioning arrangement with Cheshire East Place and Cheshire and Merseyside Integrated Care Board, EOLP was approached to facilitate a system response to reducing admissions to hospital among people who are in their last 90 days of life. Delivery of the project calls upon EOLP’s leadership and data analysis expertise and close collaboration with local NHS providers ensures that partners are fully engaged and available to provide an operational perspective into the project findings.
Progress to date
- Designed and coordinated the collection and analysis of quantitative data from key ‘touch point’ services that have the biggest potential to influence admissions from home in the last 90 days of life, including care homes.
- Identified and reported on a range of primary care, acute hospital and out of hours service metrics, with data broken down to care community level to identify variation.
- Initial findings shared with the Cheshire East Place Palliative and End of Life Care Strategic Group. This included identifying variation between different localities/care communities, rural vs urban areas and support out of hours. The analysis has also shown that having advance care plans in place correlates with reduced hospital admissions.
Next steps
Feedback from the group about their priorities will now be used to design and implement data “deep dives”. This will enable a more detailed study of issues including early identification, admission trends for specific demographics, reasons for admissions and length of stay.
Although this project is ongoing, some potential areas for quality improvement at this stage include enhancing access to seven-day services and urgent care alternatives, analysing outcomes for cancer patients and those with other conditions and exploring the effectiveness of current community resources like virtual wards. These are subject to further discussion and agreement by partners who make up the Strategic Group.