I realised last week, how it can make things so much easier when you have a strong emotional connection with your work, but it can also make it tougher. This reflection came about as I have just commenced work with the Airedale NHS Trust, learning more about their palliative care service called The Gold Line, a dedicated telephone service that supports people with a deteriorating health condition or serious illness who are in their last year of life.
I spent time last Friday morning at the Airedale General Hospital with Dr Linda Wilson, a Consultant in Palliative Medicine, to hear about how Bradford and Airedale have developed this important service. As I heard about their experiences and what they have learnt about information sharing to support palliative or end of life care, it made me think back to my past experiences of these care services when my Mum was ill.
Dr Wilson explained that the starting point for the Gold Line service was after Airedale NHS Foundation Trust had completed a strategic review of the district’s end of life care provision and was then successful in securing funding from the Health Foundation to help support delivery of the service improvements they had identified. The Gold Line service, which formed part of a wider programme alongside professional training and development and development of an Electronic Palliative Care Coordination System (EPaCCS), was launched in Airedale in 2013 and then expanded to cover Bradford in 2014.
These discussions made me remember and reflect on how towards the end of her life, my Mum had a number of different health and social care professionals visiting her, including her GP, a District Nurses and Macmillan and other specialist nurses. Dr Wilson explained how the Gold Line aims to coordinate all of these services that contribute to an individual’s care and give a single point of contact for people to call at any time when they have a concern.
Currently the Gold Line provides twenty-four hour telephone support to around 1,200 patients who have been referred to the service by their GP. The Gold Line support extends to carers and professionals and covers the period both before and after death. The service is delivered from Airedale Hospital’s pioneering telemedicine hub, which also provides telemedicine services for care homes and prisons both within and outside of Bradford and Airedale. Dr Wilson described how when a person calls the Gold Line they are able to speak to a nurse who can access their shared electronic patient record. This is facilitated through Bradford and Airedale’s Integrated Digital Care Record (IDCR) that brings together an individual’s health and social care information in to a single shared record. The nurses have a tailored view of a person’s shared information and can use this to assess risk, inform decision making, make referrals and provide emotional support as necessary.
The Gold Line currently resolve 40% of calls at the first point of contact and the other 60% are referred on using a menu of options available such as admission to a hospice or requesting a visit from the specialist outreach team. As Dr Wilson says ‘the success of the Gold Line is dependent on both the sharing of information and also the personal skills and qualities of our skilled and caring telemedicine nurses ’
A full evaluation of the Gold Line is just being completed but interim evaluation has highlighted the immediate benefits and impact of being able to share relevant health information. Airedale has achieved some of the lowest figures in the country with only 14% of those register with the Gold Line passing away in a hospital compared to the national average of 50%.
Qualitative evidence also highlights that patients and carers value having a single point of contact that can access and use all of their relevant health information. ‘This means that in the middle of the night, when people are feeling very ill, stressed or panicked, they do not have to worry about which different service to call and don’t have to go through re-telling their story’ said Dr Wilson.
Dr Wilson also pointed out that before the Gold Line was in place often in desperation people who are in the last few months of their life or their carer would end up calling 999. This then resulted in patients being taken to Accident and Emergency services (A&E) and being admitted in to hospital. This was something that was both avoidable and often not what the patient wanted. People referred to the Gold Line have also highlighted that simply knowing that the services is there and that they could speak to someone at any time of day or night is invaluable.
It is this feedback and evidence that makes me think how good it would have been for my Mum, my family and for me, to have had something like the Gold Line available when my Mum sadly approached her last few months.
You can hear more about people’s experience of the Gold Line and the impact it has had on them in a selection of short films and be inspired by the Power of People. These films bring health care improvement to life – the personal stories behind change. The films show the power of what can be achieved when people are given the time and support to innovate. These powerful and emotive films are being launched with the Health Foundation this Thursday in London and locally in Keighley the following week.
I will continue to work with Bradford and Airedale over the next couple of months to explore the Gold Line and share the learning they have developed around information sharing so keep returning to our website for the latest updates.