Modern matron's role praised for impact on end of life care
Michelle McKidd reveals how her unusual role, which spans hospital, community and social services, is breaking new ground in delivering palliative and end of life care
Michelle McKidd reveals how her unusual role, which spans hospital, community and social services, is breaking new ground in delivering palliative and end of life care.
Michelle McKidd’s job is unusual for several reasons. First, her post is jointly funded by Northumbria Healthcare NHS Foundation Trust and the Marie Curie charity, and second she works across hospitals and community services to ensure they are knitted together to provide the best possible care for people approaching end of life.
As a modern matron for palliative and end of life care, Ms McKidd’s job is to ensure staff in community, acute and social care are working as a team to respect patients’ wishes and help them receive individually tailored care.
‘Marie Curie wanted to reach out to more people and support them, so my role is to integrate teams across the hospitals and the community,’ says Ms McKidd.
‘When a patient is ready to go home, we make sure that the community team know about it and are given all the details about what the patient needs. They can accompany a patient home after they are discharged from hospital to ensure a smooth transfer of care to community teams who are working with patients and their families,’ she says.
Michelle McKidd is the only modern matron for palliative and end of life care in the Northumbria region
Ms McKidd works closely with palliative care hospital liaison teams based at North Tyneside General Hospital, Wansbeck General Hospital, and the Northumbria Specialist Emergency Care Hospital; and a palliative care rapid response team in North Tyneside.
The hospital liaison team has Marie Curie nurses in the community, alongside Northumbria specialists nurses and palliative care consultants. They support patients in getting home from hospital and ensuring that a care package is in place so that patients can remain there. The team also provides symptom control and emotional support to improve the quality of life for patients and their families.
The Marie Curie/Northumbria palliative care partnership was shortlisted for an award by the National Council for Palliative Care
Electronic alerts come via email to the nurses’ phones to tell them when a palliative care patient has come to hospital. This enables the nurses and consultants to go to meet the patient and provide specialist support.
The palliative care rapid response team gives urgent care and support to people at home. It has Marie Curie nurses working in the community, alongside palliative care clinical nurse specialists and an on-call palliative care consultant. They liaise with hospital staff to support people to get home from hospital, with the right care in place when they get there. Like the hospital liaison teams, they help with symptom control and give emotional support.
The rapid response team is available from 9am to 10pm seven days a week, which means they can support patients in going home from hospital outside of normal office hours. Northumbria Healthcare NHS Foundation Trust delivers hospital and community health services in Northumberland and North Tyneside, and adult social care services in Northumberland in partnership with Northumberland County Council.
At the beginning of her morning shift, Ms McKidd typically calls hospital palliative care units to offer advice and support. ‘It may be that they have reached a stumbling block in getting someone home from hospital and they need help in finding a solution. This might be organising community-based equipment, such as a hospital bed or a hoist to help with moving. Or it might be giving approval to bring in extra staff to provide additional support when there are patients with particularly complex needs, for example a patient who is at risk of falls.’
Ms McKidd always asks whether units have enough staff for the day. ‘If extra staff are needed, there is a process in place using bank staff or overtime. Whenever we do this, our priority is to make sure we identify staff who have a clear understanding, or experience of, working in that unit, because it is a specialist unit,’ she explains.
Figures show that the partnership helps more than 1,000 patients with potentially life-threatening conditions a year, around twice the number that were given this kind of support before the programme began in 2014.
The National Council for Palliative Care shortlisted the Marie Curie/Northumbria partnership in the End of Life Care Champions category for its Palliative Care Awards 2017.
Ms McKidd’s team did not win, but the judges were impressed.
‘This partnership coordinates essential timely discharge and support for patients combined with a rapid response team preventing unnecessary admissions. It is a very good example of partnership working between the voluntary sector and the NHS, with the aim of enabling people to be at home when they die, if it is their choice,’ they commented.
‘The special modern matron role is interesting; someone who can coordinate between the different areas concerned. The use of technology in helping with their aims is good, without losing the human touch. This is a new liaison between a palliative care hospital and a rapid response community team.
'This leads to fully integrated care, more people dying in their place of choice, reduced hospital admissions, better care and a vast increase in the number of patients seen. It also includes the creation of a modern matron approach,’ they concluded.