Hospice Contact Details
|Peace Hospice Outreach Palliative Care Educator
Covering Watford, Three rivers and Hertsmere
|Call the Learning & Development team on: 01923 330 330
|Garden House Hospice
Phone: 01462 416788
Switchboard: 01462 679540
|The Hospice of St Francis
Phone: 01442 869553
|Contact: Wendy Freeman, Care Home Educator
For general enquiries, training bookings or tailor made sessions please contact firstname.lastname@example.org
Medical Examiner Service contact details
The medical examiners service is a service provided to help streamline the process for getting a death certificate and scrutinising deaths in the community.
|East and North Herts Trust
|West Herts Trust
|Princess Alexandra Hospital Trust
Advance Care Planning
Advance Care Planning allows a person to plan their future care and support. This can include medical treatment, DNAR’s and any forms of care that may be required as they reach the later stages of their life. Advance care plans should be done while the person in question has capacity to make their own decisions.
Whilst not everyone will want to make an advance care plan, it may be especially relevant for people at risk of losing mental capacity (i.e. through progressive illness) and people whose mental capacity fluctuates (i.e. through mental illness.)
Click here for the HCPA Advance care planning documents summary
For more resources, please refer to the NICE Guidelines and Toolkit
Click here for a video from Garden House Hospice Care answering questions about Advance Care Planning
Treatment Escalation Plan
A Treatment Escalation Plan (TEP) is a communication tool which is helpful in hospital when a person with serious illness has the potential for acute deterioration or may be coming towards the end of their life. Sometimes doing everything possible may actually lead to harm – to more suffering and distress rather than less – and without any particular gain. What can be done and what should be done may not necessarily be the same thing. Treatment Escalation Plans should be discussed and made based on personalised realistic goals rather than ‘one size fits all’ treatment.
Crucially, a TEP provides on-call hospital staff with immediately accessible guidance about how to respond to an individual in times of crisis, especially out of hours and at weekends. A TEP becomes particularly important when there is agreement that interventions or referrals for more intensive care that are contrary to a person’s wishes or are futile or burdensome should not be undertaken. Equally in many patients who may have an agreed DNACPR, a TEP clarifies all the treatments and care that should continue.
» Click here for a Treatment Escalation Plan form
Universal principles for advance care planning
The Universal Principles for Advance Care Planning has been jointly published by a coalition of partners, including SCIE. Advance care planning is a voluntary process of person-centred discussion between an individual and their care providers about their preferences and priorities for their future care.
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. Rolled out across East and North Hertfordshire from 5th September 2022, the ReSPECT paperwork is designed to prompt person centred discussions around individuals needs and wishes at end of life, including decisions about resuscitation.
ReSPECT forms are now starting to be used as well as the traditional red DNACPR forms to record decisions about resuscitation, therefore it is important that you and your staff are familiar with it.
To find out more about the ReSPECT forms, please click here for FAQ’s.
The new ReSPECT paperwork (Recommended Summary Plan for Emergency Care and Treatment) was rolled out across East and North Hertfordshire in September. It has also been introduced in South and West Hertfordshire care homes under a new Advance Care Planning project.
ReSPECT forms not only include a decision on CPR on the paperwork but enable service users to have a holistic conversation around end-of-life care plans with their healthcare professionals. Individuals coming out of hospital who may have previously had a DNACPR form in place are now likely to be coming out with the purple ReSPECT forms instead. It is therefore important that those who support individuals at the end of their life have an awareness of the new paperwork to enable you to best support your service users.
Care professionals need to have an awareness of the ReSPECT forms, where these are kept for each individual they support, and the significance of these documents including an understanding that these count as a DNACPR forms. Managers of care providers need to ensure all staff are aware of and have had training on how to interpret these forms, as well as how to use them in emergency situations.
Q: If an individual has an existing original DNACPR form, will this still be valid?
A: yes, all pre-existing DNACPR forms are still valid and should be upheld as normal. However, an individual with an existing DNACPR may then have a ReSPECT discussion and a form given to them which would then replace their old DNACPR form.
Q: Is a ReSPECT form a legally binding document?
A: no, in the same way that a DNACPR form is not legally binding. However, clinicians should have a valid reason for not adhering to a ReSPECT document. For a decision around end-of-life care (including CPR) to become legally binding, it must be included in an Advance Decision to Refuse Treatment document.
Q: Will all individuals who have a ReSPECT document not be for CPR?
A: no, this is on an individual basis and is recorded on the bottom of the first page of the ReSPECT document. Some individuals who have had a ReSPECT conversation may still be appropriate for CPR, and this would be recorded on the document. In an emergency situation, care professionals should always check the document for a decision around CPR and never assume that just because someone has a ReSPECT document they are not for CPR.
Q: Are ReSPECT forms valid even if an individual is admitted to or discharged from hospital?
A: yes, ReSPECT forms will follow an individual throughout their journey in the healthcare system. However, it is good practice to review the ReSPECT document regularly, especially on admission to and discharge from hospital to ensure these are still accurate and reflect the current status of the individual.
For more information about the ReSPECT paperwork in East and North Hertfordshire, please see below contact email addresses:
Mark Andrews- email@example.com (CCG)
Sarah Bell- firstname.lastname@example.org (Garden House Hospice Care)
Jemma Finch- email@example.com (HCT)
Beth Williams- firstname.lastname@example.org (Isabel Hospice)
Resus- email@example.com (ENHT)
For more information about the ReSPECT paperwork in South and West Hertfordshire (care homes only), please see below contact email address:
The Community Hubs and Health Memory Café provide a welcoming, friendly space for people to come along for a cup of tea and a chat, talk to and be listened to by one of the Garden House Hospice team members.
At the Hospice, they feel passionate about reaching more people earlier in their journey to receive their support and care, giving them confidence to live well and enjoy life to the fullest.
Community Wellbeing Hubs
The community are welcome to join a team of Hospice Volunteers for a chat, meet new people and get some support and advice in four Hubs across the area.
These weekly drop-in sessions are an opportunity to:
- Join the team for a cup of tea and a chat
- Talk and be listened to by one of their team members
- Gain information about their therapies and support services
- Join in a seated exercise group
- Take part in creative and fun activities that promote health and wellbeing
- Feel more in control and live life to its greatest potential.
Your nearest Wellbeing Hub
Symonds Green, Stevenage
Location: Symonds Green Community Centre, Filey Close, Stevenage, Herts, SG1 2JW
When: Every Monday 10:30am – 12:30pm
Roaring Meg, Stevenage
Location: The Community Arts Centre, Roaring Meg Retail Park, Stevenage, SG1 1XN
When: Every Monday 10.30am – 12.30pm
Location: The Coombes Community Centre, Burns Road, Royston, Herts, SG8 5PT
When: Every Monday 2pm – 4pm
Location: The Ernest Gardiner Centre, Pearsall Close, Letchworth, SG6 1QZ
When: Every Friday 10.30am – 12.30pm
For further details please contact Richard Julian on 07485 027596 or email firstname.lastname@example.org.
Healthy Memory Café
Do you know someone who is worried about their memory or the memory of a loved one? The Healthy Memory Café is a safe space for people to drop in and chat to others and professionals for support and information.
Location: Create Community Hub, 19-29 Station Road, Letchworth Garden City, Herts, SG6 3BB
When: Last Thursday of every month, 10am to 12pm
For more information call 01438 792190 or get in touch with our Admiral Nurse, Lucy.
Hertfordshire Compassionate Neighbours Schemes
Compassionate Neighbours offers emotional and social support for people living with a serious or terminal illness and are who experiencing loneliness or social isolation. Throughout Hertfordshire the local hospices offer varying schemes for their location.
CQC quality and equality assessments
The Care Quality Commission (CQC) plans to start assessing the quality and equality of end-of-life care provided by adult social care services. The move follows a review that found some groups of people get poorer quality care at the end of their lives because health and care services do not understand or fully consider their needs.
These groups include ethnic minorities, the homeless, the frail, prisoners and people with mental health conditions, dementia or learning disabilities. The CQC’s A Different Ending review found that a lack of understanding of the specific needs of these and other groups of people is preventing good care for the dying. People with dementia, for example, “need the opportunity to talk about their end-of-life care wishes and preferences before the last year of life as they will progressively lose the capacity to make decisions”.
In response to the findings, the CQC said it now intends to start assessing the quality and equality of end-of-life care provided by services, including adult social care, that are not currently given ratings for their work in this area.
This, the review said, means CQC inspections will “include an assessment of the quality of end of life care and whether it is meeting the needs of everyone, including people from equality groups and people whose circumstances may make them vulnerable, and report on this consistently”.
Resources and Webinars
The following information is intended to offer resources for staff within Adult social care provider services when working with people with care and support needs, including their carers to help people feel supported around end of life conversations and care planning.
- Supporting staff with difficult conversations
- Holding difficult conversations guides and resources
- End of life Palliative care resources and organisations
- Bereavement counselling and resources
- Hospices in Hertfordshire
|End of life care documentation – 26.01.23 – Webinar recording
|End of life care documentation – 26.01.23 – Webinar slides
|‘End of Life – Managing Breathless’ – 24.02.21 – Webinar recording
|‘End of Life – Managing Breathless’ – 24.02.21 – Webinar slides
|‘Remote Verification of Death’ Webinar – 04.06.21 – Webinar recording
|‘Remote Verification of Death’ Webinar – 28.05.21 – Webinar recording
|‘Remote Verification of Death’ Webinar – 28.05.21 – Webinar slides
|‘Advance Care Planning – what does it mean?’ – 13.05.21 – Webinar recording
|‘Advance Care Planning – what does it mean?’ – 13.05.21 – Webinar slides
|‘Significant conversations at End of Life’ – 17.04.21 – Webinar recording
|‘Significant conversations at End of Life’ – 17.04.21 – Webinar slides
|‘Significant conversations at End of Life’ – 17.04.21 – Q&A’s
|DNACPR Easy Read [.PDF]
|DNACPR Support Guide
|Top Tips for Tricky Times: Supporting residents at the EOL uncertainty [.PDF]
|“What If” Celebrating My Life [.PDF]
|Six steps to success in End of Life Care during COVID-19
|Hospice of St Francis – Care Planning Guidance and Template [.PDF]
|Queens Nursing Institute – EOL Resources [.PDF]
|Talking to relatives [.JPG]
|Non-Injectable PRN [.PDF]
|British Geriatric Association
|Centre of Advanced Palliative Care resources
|Gold Standard Framework
|EOL E-Learning Resource- Royal College of General Practitioners
|Palliative & End of Life Care
|Anticipatory Meds for End of Life Care
|Having The Conversation – Scenario
|Adults Sim Scenario: COVID-19
|Teaching of the ReSPECT tool/ DNA-CPR discussion
|MDTea by the Hearing Aid Podcasts
|Supporting staff following deaths in care home environments
|Supporting families at a distance
|Health contact sheets for hospice referral