A PROJECT led by Somerset healthcare workers to support end of life care has reached the final of the Patient Safety awards.

Somerset healthcare workers have been involved in Care First Fund Later, a trial project to support patients nearing end of life to help achieve their wish of being able to spend their remaining time at home.

Care First Fund Later – or CareFFul for short – is where patients are discharged home with a package of care, regardless of whether other funding streams are being applied for.

The sometimes-lengthy process of applying for other funds, and then securing a package of care, often delays patients from being able to go home.

The CareFFuL initiative prioritised patients’ wishes by enabling them to be discharged from hospital within 24 hours, making the whole process easier, by-passing lengthy funding applications, and prioritising care, using Somerset NHS Foundation Trust’s rapid response teams.

Previously, it took over six days on average for patients receiving end-of-life care for a funding decision before plans were made to help people go home.

The project also caught the eye of judges at the popular online healthcare news outlet, Health Service Journal, where it made the final of the Patient Safety awards.

Jo Morrison, a consultant gynaecological oncologist at Somerset NHS Foundation Trust, said: “Colleagues involved in the discharge of patients from hospital were concerned that it was taking too long for ‘fast-track’ funding decisions to be made for patients who were really close to the end of their life.

“This meant that one in three people were dying in hospital, often not in line with their wishes, which caused huge distress to families, and this just didn’t feel right.

“During the Covid-19 pandemic, the application process for funding was stood down to allow prompt discharge and we wanted to see whether we could replicate this in some way.”

Fiona Robinson, a clinical transformation advisor at Somerset NHS Foundation Trust, said: “The outcome of this work was incredible, as although 1 in 10 patients still died in hospital, mainly because they were too close to the end of their life for our project to help, it was still a massive improvement on the previous 1 in 3 dying in hospital. We were able to help most people to get home within one day.

“The project also meant we freed up an extra 550 hospital inpatient beds, that would have otherwise been occupied by a patient who wanted to be at home but was awaiting a funding decision or placement."

Ally Witney, clinical lead for Somerset NHS Foundation Trust’s end-of-life care coordination team, said: “Overall, it’s a great project about making the right thing, the easy thing, but we aren’t able to extend it widely, even though it’s happening in other areas of the country.

“The future of the project will very much depend on our health and social care community coming together to look at how we can find sustainable funding to make this happen for the benefit of our patients – I really hope we can.”