Agenda item

9.1

The report which shared details of the South Yorkshire Integrated Care Board’s All Age Palliative and End of Life Care Strategy and offered Members an opportunity to give feedback, introduced the ReSPECT (Recommended Summary Plan for Emergency Care and Treatment)  project and shared details regarding the ongoing funding of specialist therapeutic bereavement services in Sheffield, was introduced by Louise Potter (PEOLC [Palliative and End of Life Care] Commissioning Manager, Sheffield Place SY ICB, [South Yorkshire Independent Commissioning Board]), Lucy Crowder (ReSPECT Project Manager), Dr. Hannah Weston (GP and PEOLC clinical advisor for Sheffield Place, SY ICB), Jane Howcroft (Head of Commissioning, Long Term Conditions, PEOLC, Sheffield Place, SYICB) and Joanna Rutter (Health Improvement Principal, Public Health, Sheffield City Council).

9.2

Jane Howcroft explained that the Health and Social Care Act 2022 gave the ICB a statutory duty for Palliative and End of Life Care, and this had necessitated the drawing up of the strategy.

9.3

Presentations on the Palliative and End of Life Care Strategy and on Bereavement Services, subsequently published on the Council’s website, were delivered by Louise Potter who advised that the consultation link for feedback on the strategy would be kept open for Members of the Sub-Committees to comment, until the following Monday.

9.4

Joanne Rutter explained that there was a particular need for feedback regarding how Bereavement Services, which were evolving since the Covid Pandemic, should be owned and governed.

9.5

Members expressed concerns that NHS funding for bereavement services was due to end, particularly as there were economic reasons for its continuance as people taking days off work associated with grief was costly. 

Louise Potter advised that the yearly commissioned costs for services relating to the strategy had been as follows: Cruise £97,000, Faith Star £47,000, Mind £75,000. Joanna Rutter confirmed that the funding had come from Covid Recovery funds, Public Health reserves and the ICB. Cruise acted as a gateway to direct people to the correct help and the organisations worked collaboratively.

9.6

Members welcomed the proposal to have information on bereavement services available in one place on a website and in readily understandable language.   A suggestion was made that local businesses could be approached for funding for bereavement services.

9.7

A workshop was being scheduled later in the year which would give Members the opportunity to discuss bereavement services in more detail.

9.8

A question had been received from Dave Berry who attended the meeting to ask the question:

"I have friends who have had poor experience of the DNR and the recently introduced Respect process. How is the consent and involvement of the patient and family to be evidenced within the process. Will it be formally recorded or signed for by the family within the documentation process?"

Dr Weston advised Mr Berry that his question would be addressed in the presentation on the ReSPECT project.

9.9

A presentation on the ReSPECT project, which was subsequently published on the Council’s website,  was delivered by Lucy Crowder

9.10

The Chair referring to the public question asked how a patient would have had a ReSPECT plan withOUT their family being consulted.  Dr Weston advised that this was disappointing and was not best practice as whilst it was a medical decision, family/carers should be involved.  She stated that she would encourage the family mentioned by Mr Berry to find out what had happened via PALS (Patient Advice and Liaison Service). 

9.11

Members asked where accountability for the ReSPECT programme lies. Healthwatch had had feedback which relayed experiences similar to that of Mr Berry and had said that more time for discussion and reflection as part of the process, would have been useful.

Dr Weston explained that plans could be formulated in various settings and were a paper document which should remain with the patient.  The plan should be reviewed if circumstances, care settings or the wishes of the patient changed. This should be outlined on the form itself but there was scope for it to be spelled out more clearly.  The process was a collaboration with the patient and the family, but the final say was with the clinician and it could be beneficial for the family to feel that the final decision did not rest with them. “Not For Resuscitation” did not mean that other care was withdrawn.

9.12

Louise Potter advised that the change from “Do Not Resuscitate” to ReSPECT would take up to 2 years to embed, and was being phased in at the same time as the previous process was being phased out.  Staff were being trained. The information being held electronically was on the forward plan. Lucy Crowder stated that an audit of organisations who had adopted ReSPECT was being conducted and this would be used to set benchmarks.  The audit would also look at complaints and assess performance against national standards.  Dr Weston explained that patients were being encouraged to approach GPs to initiate ReSPECT programmes.

9.13

The Chair stated that regarding the earlier discussion on Bereavement Services, she was concerned that according to Healthwatch findings, the further the service was away from hospital acute care, the lower the customer satisfaction was.  She suggested that the strategy should not be fully owned by the ICB but should be co-owned with other partners such as the council, voluntary organisations and hospices.  Jane Howcroft responded that the strategy was created with partners and their logos would be included but the idea of co-ownership could be explored further, and Compassionate Sheffield should be invited to the proposed workshop.

9.14

RESOLVED: That the Sub-Committee notes the update.

(NOTE: During the discussion of the above item the Sub-Committee agreed, in accordance with Council Procedure rules, that as the meeting was approaching the two hours and 30 minutes time limit, the meeting should be extended by a period of 15 minutes).