Description of the contract
Hywel Dda University Health Board is seeking to procure Community Advance and Care Planning (ACP) for the Communities within Tywi/Taf cluster area (2T’s). ACP remains a priority for End-of-Life care at a Welsh Government Level and A Healthier Wales strategy. The Tywi/Taf Cluster acknowledges ACP is an important part of the transforming clinical services agenda for Hywel Dda University Health Board.
Demand for palliative care in the community is forecast to nearly double by 2040. Projections indicate that the need for palliative care will rise substantially over coming years especially at home or in care homes.
Welsh Government’s Quality Statement for palliative and end of life care says that all people identified as having palliative care needs will be given the opportunity and support for conversations with someone well placed to discuss their personal needs, wishes and preferences for care at the end of life, through regularly reviewed Advance and Future Care Planning. The Statement also highlights that people, approaching the end of their lives and their families and carers should be treated with dignity and respect and have their personal beliefs and needs, including Welsh language (and other language need) and any spiritual or religious beliefs, considered as part of their core care.
ACP can be used as an early intervention to facilitate patients remaining in their preferred place of care. ACP has facilitated hospital discharge and prevented hospital admission. The carer burden is relieved by having an ACP in place. The family member has what they have described as a ‘prompt sheet’ to know what their loved one would have wanted should they not be able to speak for themselves. ACP gives our population voice and control over decisions which are impacting on their health care. It enables the population to remain in their preferred place of care.
The 2Ts has a significantly higher population of over 65s at 24% compared to the Welsh average of 18.7% and this has been steadily increasing since 2012. This, combined with the geographical challenges faced within the Cluster can have a significant impact in terms of accessing services and service delivery. By having Advance Care Plans in place this can ensure arrangements can be made in advance to reduce unwanted or futile invasive interventions, treatments, or hospital admissions, guiding those involved in care to provide appropriate levels of treatment (six out of seven patients who engage in robust advance care planning die as per their preference outside of hospital)
The service will achieve two (2) core objectives:
Objective One
Providing support to people through ACP conversations to develop a plan which enables them to remain in their preferred place of care and achieve what matters most to them at the end of their life.
Objective Two
Further improve awareness, knowledge and understanding of ACP. ACP Training and awareness sessions to be delivered to health and social care professionals working across primary/community care.
The contract duration will be One (1) year with an option to extend for a further one (1) year with no commitment due to non-recurrent fixed funding. and the award will be made to a single provider.
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