Professor Max Watson is a palliative care clinician and Director of Project ECHO at Hospice UK in London. In this background post to his longer article published in the November/December issue of the European Journal of Palliative Care, Max explains how the ECHO methodology can bring hospice care to more patients.
Over the years there have been several initiatives that have promised much in terms of improving access and availability of palliative care services to more people in need. The dramatic changes in the demographics of the UK make this pursuit ever more important. It can be anticipated that one in eight of the current population will reach the age of 100, which is a wonderful success story, but it is also likely that when their telegram, or email, arrives from the Queen it will be read in between taking a significant selection of treatments for a wide range of co-morbidities.
So how can we respond to such growth in demand when the headlines over Christmas tell of an NHS (national health service) in crisis with overrun accident emergency departments, routine operations cancelled and unprecedented waiting times to be seen out of hours?
Somehow, we need to develop new ways of delivering our services and take fuller advantage of our healthcare professionals’ skills. At the same time, we need to mobilise non-professionals and volunteers, many of whom will come from that same older generation who have the capacity and the ability to contribute to and engage with the delivery of social and health care support in their own communities.
Project ECHO (Extension of Community Healthcare Outcomes) is a not-for-profit movement to improve care by gathering together a community of practice for learning and support with the goal of improving decision-making by collaborative problem solving using video conferencing. Typically, an ECHO network will be championed by a leader with a vision to improve service delivery and will include an initial meeting at which the community of practice will establish the curriculum and the meeting dates. Each meeting involves a didactic teaching session followed by case presentations. Each meeting is supported by a trained facilitator, with dedicated IT and administrative support using a hub and spoke model and video conferencing software that is provided by ECHO, because of its ease of use and narrow bandwidth.
An example of ECHO in the palliative care context might be a hospice using ECHO to link in with care homes, or pharmacists, or out of hours services in their area, using a tele-mentoring approach to build a community of practice linking central and local community expertise to improve the quality of clinical decision-making. ECHO as a methodology allows for the governance and building of such networks that extend beyond healthcare professionals to supporting carers in the community or helping communities to better understand and support the frail, or those living with chronic disease.
Hospice UK is committed to the use of ECHO methodology so that the reach of hospices can be extended and more patients receive the support that they need. Already, more than 100 organisations have expressed interest in becoming ECHO hubs, with immersion training for new hubs starting in March 2018. Please see the links below if you would like more information and watch the short video.
Links and resources
Read the full article in the European Journey of Palliative Care
This post relates to ‘At the hub of things’ by Max Watson that is published in the November/December 2017 edition of the European Journal of Palliative Care (EJPC) (vol. 24 (6). (If necessary, choose ‘Browse the archive’, 2017/November/December).
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Read more posts relating to articles published in the European Journal of Palliative Care on the EAPC Blog.