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Nurse-led end of life service cuts admissions

Review finds London care coordination centre could save the NHS £350,000 a year, but needs more nurses to cope with demand
End of life service

A nurse-led end of life care service has led to fewer hospital admissions and could save the NHS £350,000 a year, an independent review has found.


Head of the Wandsworth Care Coordination Centre and team lead Cathy Maylin, right, with coordinators Khine Moi and Beverley Preddle.

The Wandsworth Care Coordination Centre, based at Royal Trinity Hospice in south London, is a seven-day service that arranges rapid care and equipment packages to enable patients to die at home, or another place of their choice. 

The centre supported more than 400 patients and their families during the first year of a two-year pilot, which is due to end in March 2017.

Efficiency savings

A review shows the service could save the NHS about £350,000 in care improvements and efficiencies, including avoiding hospital admissions. However, these savings over the first year of the pilot are offset against the cost of delivering the centre.

The review by research consultancy OPM Group also found:

  • 77 avoided admissions in the first year of the pilot, which began in February 2015.
  • Patients are discharged from hospital 2 days earlier, on average.
  • Around 2 hours of clinical time is saved for every patient referred.
Care options

The service, which is run in partnership with Marie Curie and St George’s University Hospitals NHS Foundation Trust, has a helpline for patients, families and professionals.

It also has a dedicated end of life community nurse and a team of Marie Curie health and personal care assistants who offer specialised care at home.

The review praised the nursing care, but said more nurses were needed to meet current need and boost future capacity.

End of life care community nurse Gilly Best supports up to 100 nurses across six sites in Wandsworth, and said much of her work involes talking to families and patients. ‘People want to know what death looks like, what to expect,’ she said.

Increasing demand

Head of the centre and coordination team lead Cathy Maylin said demand for the services was increasing due to awareness and need.

‘The model works well because it’s a collaboration with other organisations,’ she said.

‘There will be a final internal report and Wandsworth Clinical Commissioning Group is working tirelessly to secure funding for a substantive service.’

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