End of Life Care Under Review in West Berkshire

End-of-life care in West Berkshire is under the microscope at next week's health scrutiny meeting as projections show around 3,100 more residents over 15 years and the 65+ group set to rise nearly 30% by 2040. The number of children and working-age adults is projected to fall.

A council report says palliative and end-of-life care faces rising demand, more complex cases and workforce pressures, especially in district nursing. Recruitment is tough because the local jobs market is competitive and London often lures staff with higher pay, affecting roles including the newer West Berkshire Hospice at Home service.

Digital systems vary across providers and out-of-hours cover needs bolstering, the report adds.

Specialist provision largely comes via Sue Ryder. The Duchess of Kent Hospice in Reading is the main inpatient unit, with 10 beds for West Berkshire and nearby areas. Sue Ryder also arranges urgent same-day admissions where possible.

There are eight flexible palliative beds at West Berkshire Community Hospital, plus outpatient and day services, and some beds at Wallingford Community Hospital in South Oxfordshire.

Community care is central: multidisciplinary teams including specialist consultants, nurse specialists and primary care aim to support people at home. The Thames Valley ICB has broadened the local model to include Hospice at Home services, rapid response teams, a virtual ward and a clinical advice line, coordinated through a 24/7 single point of access.

The single point of access operates seven days a week from 8am to 8pm. Referrals can be made at any time and are processed during these hours by care navigators supported by clinical nurse specialists and registered nurses.

Dementia palliative care has extra challenges: it's hard to tell when someone is nearing the end of life, advance care planning can be inconsistent, pathways are fragmented and specialist dementia expertise is limited, leading to crisis care and avoidable hospital admissions.

Services like Hospice at Home and the virtual ward help people with dementia stay in familiar surroundings. Sue Ryder uses a dementia-friendly approach, with longer appointments and verbal and non-verbal communication techniques. BHFT runs a memory clinic and Older People's Mental Health Service and can refer people to Sue Ryder or the care home palliative care nurse where appropriate.

The report urges a focus on sustainability, workforce capability, earlier identification and planning, and better digital links.

"Maintaining momentum in these areas will be essential if the system is to meet growing demand while continuing to provide compassionate, coordinated and high-quality care for West Berkshire residents," it says.

Niki Hinman, Local Democracy Reporter