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New community nursing role for end-of-life care

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A new type of community nursing role is due to be rolled out in east Yorkshire from this week.

The new role, called a ‘Health and Social Care Assistant’, is to be introduced in Hull to nurse end-of-life care patients in their own homes. There will initially be nine HSCAs with more to follow. There is enough funding for 12 full time equivalents.

The new service is intended to ‘complement the excellent work carried out by the district nursing team’ and work with other partners, including hospices and cancer support nurses, according to City Health Care Partnership – the newly created provider arm of NHS Hull, formerly Hull Teaching PCT.

What sets the HSCAs apart from existing services is their lack of visiting time limits and the range of support they provide, said Sue Pender, a modern matron with City Health Care Partnership.

Ms Pender said the vast majority of people wanted to die at home and the new service was about ‘making the home a supportive environment’.

The assistants are not confined to clinical care and may provide assistance with hygiene and other comfort measures, or general activities such as making a cup of tea.

Additionally, while a district nurse or Macmillan nurse would normally visit and then move onto the next appointment, she said the HSCA can stay with the patient as long as the patient wants them to – from five minutes to several hours.

An HSCA could spend their entire shift with one patient if needed, handing over to the next assistant and therefore providing 24-hour care, said Ms Pender. Equally, they could ‘pop in and out’ in multiple visits through the day if the patient requested it, she told Nursing Times.

Ms Pender said NHS Hull was supporting the service with funding of £240,000 per year, which would be ongoing – dependent on positive evaluation and monitoring.    

The service, developed by the city’s out-of-hours nursing team, was based on ideas contained within the Department of Health’s national end-of-life care strategy, published last July.

The team wanted to develop a patient-led service with a ‘focus on individual needs and high-quality care’ and bring a ‘fresh approach to methods used when nursing those with terminal illnesses’.

Stewart Boynton, head of the out-of-hours nursing team, said: ‘Our new service offers a fantastic mix of skills and we have chosen an excellent team to go out into the community for the first time.

‘Through a quality driven and patient-led service, we aim to support the provision of round-the-clock care. Providing support to those who require vital, end-of-life care,’ he said.

The City Health Care Partnership is currently in the process of becoming a ‘not-for-profit’ social enterprise scheme – which is independent of the NHS but provides services to it – by April 2010.

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Readers' comments (2)

  • I think this is a great idea, as I have found one of the greatest hindrances to end of life care at home has been lack of suitable carers. I have found district nurses in my area less able, and sometimes I regret to say reluctant, to give time to dying patients. The hospice at home initiatives of centres like Bristol seem to have set an excellent standard, but there is still much to be done to reduce the postcode lottery. At the end of the day end of life care is going to need more resources, and it cannot be right that so much of what is provided relies on donations.

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  • I already work for end of life team in leicester as a health care assistant , Health care assistants jointed the team about a year ago , and are proving to be valuable members of the team supporting patients and family , we have now been commision, to provide a service which ables patients whos wish to die at home and are on LCP , will be able for are rapid discharge which will get a patient home with in 24hrs ,this is proving to be also a valuble srevice within the end of life sevice ,And Health care assistant with in are team are trained and supported by mangerment and trained staff to provide a specialised srevice

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