End of life care: Anne-Maria Newham's Story

End of life care: Anne-Maria Newham's Story

Anne-Maria Newham travelled to New Zealand to explore approaches to end of life care.

The Fellowship

At the time of her Fellowship in 2015, Anne-Maria was Chief Nurse and Quality Officer for NHS Erewash Clinical Commissioning Group in Derbyshire. She had grown concerned at the quality of care available for patients who are palliative or towards the end of life. Provision was inconsistent, with the level of support available to patients and their carers dependent on where and to whom they were referred. There were also no hospice beds, only outreach care in homes, which meant that if patients chose not to die in hospital or at home, there was nowhere else for them to go.

In New Zealand, there is substantial investment in hospices: they receive 75% of their funding from government, compared to 35% in the UK. During her Fellowship in 2015, Anne-Maria observed how integrated working across health and social care, and the voluntary sector, had produced clear benefits for patients in New Zealand. She was impressed by a national campaign called ‘Start a Conversation’, which encouraged families to talk to professionals in advance about what they want from their end of life care and their living will.

The Results

After returning to the UK, Anne-Maria began working with Macmillan Cancer Support on a large scale two year project to improve services and care for patients and their carers at the end of life. The project involves collaboration between community and acute healthcare services and voluntary sector providers, and emphasises the importance of taking into account the experiences of patients to inform services. A detailed scoping of the current end of life services across the health and social care sector has been undertaken.

The project is now half way through and a number of positive changes have already been put in place: Treetops Hospice are working closely with the project to improve access to bereavement support through a 24 hour telephone help line, beds have been identified that can be used for patients wishing to stay in a care home at the end of their life, and GP practices are identifying patients in need of palliative care much earlier.

Anne-Maria is now Director of Nursing and Quality at Lincolnshire Partnership NHS Foundation Trust.

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