I am asked a lot about equality of access to Hospice and Palliative Care so have gathered a few top tips if you and your service are SERIOUS about improving access...
Start at home
Look at your service, examine your referral data, look at ethnicity, diagnosis, gender, sexuality.
Do you collect it?
Do you review it?
Do you ask the right questions?
Is it reflective of your population?
Ask people about your referral process- really listen and be ready to act
How easy is it?
Do referrers know how to refer for what when?
Can they speak to you?
Who do you say no to?
Why?
Do you audit that?
Does your referral criteria regularly exclude certain people?
Ask citizens.
Particularly those who are not accessing. Again, truly and humbly listen and be ready to act.
Why aren't they using your service?
What are the messages you send out?
Do they include them?
What is needed to ensure people feel welcomed and included.
Act on it.
This one is important.
Equality of access isn't just about telling people about what you do so they understand, it's about understanding what people need
So... engagement must start with listening- we are good at listening, we teach people about it, let's do it properly.
Build true and authentic relationships and keep them.
This can be MDT working, pathway development all sorts of structure and process stuff but all of that relies on showing up and being willing to work together.
This one needs sustained work and is hugely rewarding
Do a thing.
I learned this from my work in COPD.
Develop a service which does what people need. Fatigue management, breathlessness management, carer support.
Referral to a thing that makes a difference is more acceptable than referral to "Hospice"
Measure your outcomes
Education. Education. EDUCATION

Palliative Care services remain terrified that by opening the doors they will be overwhelmed.

So, acknowledge that this stuff is done fabulously by everyone else and usually when they come to you it's because they need a bit more help
There are easy things you can do about that.
1. Deliver education programmes which mean those who need a bit more help and support from you need less over time.
2. Make the education accessible, be alongside, make it core to your teams roles.
And on this... Care Homes...
Where more people die than "home" and will increasingly do so.
If you want to do one thing to ensure that there is equity in Palliative Care to those who truly need it, support staff in Care Homes
Poverty, deprivation, structural vulnerability

This is big and needs it's own thread but...

We know people who live in poverty do not access our care

So...all of the above AND go to them, go to the people working with them, check your judging.
Know and understand trauma informed care, do everything to ensure you do not contribute to retraumatisation when people are at there most vulnerable
So I suppose what I am saying is be honest and humble in your organisations and be ready to act if you really want to make a change.
And get your theirs right in threads 😊
There are fabulous people you can follow to be inspired
@JamillaHussain1 @gemma_allen1 @JedJerwood @saskie_dorman @JonathanKoffman @ImmyKaur @NtWilderness @Lucy_Selman @heapy25 for me @RicoRKLJ and @megalightheart have challenged and inspired #keeplearning

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