Dying well at home: the case for integrated working
Practice example 4: Bungalow Beds, Sandwell
The aim of Bungalow Beds was to provide a ‘home from home’ setting where patients and their loved ones could spend quality time together and to meet both physical and emotional needs.
The bungalows provided six beds across six sites for Sandwell patients who needed end of life care. Care was provided by healthcare assistants who, over the course of the pilot, developed the skills and knowledge to care for end of life patients. Clinical interventions were carried out by general practitioners, district nurses and the community palliative care team (known as Hospice at Home).
In total, 43 patients were admitted to the bungalows. The majority of referrals came from the community, palliative care, clinical nurse specialist team. Thirty-five went on to die in the bungalows, three were transferred to hospital, three patients returned home, one went to a nursing home and one went to an assisted living facility.
Of the admissions, 72 per cent were for end of life care, 23.2 per cent were for symptom control and 4.8 per cent were to support carers. The average length of stay for patients was 12.6 days although this figure was skewed as one patient remained for 101 days due to delays with social care assessment and placement. Excluding this patient gives an average length of stay of 10.4 days.
The pilot was evaluated from 1 May to 31 October 2012. The lack of a clear financial model made it difficult to assess costs although they were likely to be less than hospice care provision. Further work will need to be undertaken if this service is re-commissioned.
Diana Webb, Sandwell and West Birmingham Hospital NHS Trust.