Abstract

Background

The North Manchester Macmillan Palliative Care Support Service (NMMPCSS) is a Macmillan-funded service created in response to a series of local challenges in the palliative care service. These included: the absence of a local hospice in a deprived area, a higher number of hospital deaths when compared to the national average, and an absence of weekend palliative support services.

The service aimed to improve experiences and outcomes for end of life patients through the development of a new model of community-based palliative care, derived from the ‘Midhurst’ principles. Core service elements include care arranged around a single point-of-access and delivery by a multi-disciplinary team, including a community-based palliative consultant, an integrated volunteer service, and collaborative working between district nurses and palliative care team. support is provided 12 hours a day, 7 days a week, alongside a 24-hour helpline.

Method

A case-study approach was used. Interviews were held with strategic stakeholders and staff; focus groups with support staff and volunteers; and internal evaluations were examined. Data were audio-recorded, transcribed, and then analysed using thematic analysis.

Results

Stakeholders reported positive outcomes. Patients reported increased satisfaction with the quality of care, increased confidence and felt more supported: better access to specialist and holistic support in the community resulted in better integrated and coordinated care. Healthcare professionals also reported feeling more informed about their patients. More widely, HCP interviewees linked NMMPCSS to the recording of more individuals on the palliative care register, fewer crisis admissions and fewer people dying in hospital.

Conclusion

Findings reflected NMMPCSS’s overall success in filling an important gap in service provision.  The study highlighted numerous positive outcomes and important enablers and challenges; these could inform the service’s future development and its replicability elsewhere.