Projects and programmes

Six Steps to Success in End of Life Care

The Six Steps to Success programme aims to enhance end of life care by facilitating organisational change. It educates and supports staff to develop their roles around end of life care.

The programme is a free, comprehensive web-based resource for facilitators. It can be used flexibly to support and empower care homes and domiciliary care organisations to implement and embed the Six Steps to Success in End of Life Care. Steps go from 1: ‘Discussions as end of life approaches’ through to 6: ‘Care after death’. It includes a set of audits so homes can monitor their progress. All aspects of the programme are underpinned by a range of evidence from different sources.

The One Step programme is a stand-alone resource covering the content of Step One of the Six Steps programme. It can run independently of the rest of the six steps. It can be completed directly via the resources on the website by an individual or a group and doesn’t need a facilitator.

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Rules of Thumb programme for people with dementia

The Rules of Thumb programme is a facilitator led education programme aimed at professionals working with people with dementia at the very end of life.

It can be delivered as an extended half day session, across several mini-sessions, or incorporated into other programmes, such as the Six Steps to Success programme. All resources are available on the website.

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Electronic Palliative Care Co-ordination System – EPaCCS

The EPaCCS programme supports health and care professionals to adopt ways to transfer palliative care summary information electronically using the Greater Manchester Care Record.

EPaCCS is used to record and share an individual's beliefs, values, preferences and other key details about their care, with their consent, as they are approaching or within the last year of their lives. The system helps coordinate and deliver the right care, in the right place, by the right person, at the right time.

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Advance Care Planning – Mayfly Training Programme

The Mayfly Training Programme supports health and social care professionals to develop and implement Advance Care Planning (ACP).

ACP is a voluntary process of person-centred discussions between an individual and their care providers about their preferences and priorities for their future care. Planning takes place while the person has the mental capacity to have meaningful conversations about their wishes. The process, which is likely to involve several conversations over time, must have due consideration and respect for the person’s wishes and emotions at all times.

The Mayfly ACP Training Programme involves a two-day Train the Trainer model for health and social care staff. It equips and empowers them to deliver a one-day ACP course to frontline staff.

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EARLY Identification

This project works with Primary Care Networks from across Greater Manchester and Eastern Cheshire to implement the EARLY identification electronic search tool, linked with clinical validation, which identifies people who are likely to be in their last year of life.

EARLY Identification supports clinicians to have timely conversations and develop a shared decision making approach, empowering the person and their carers in the last year of life.

If people at the end of life can be identified early enough, there’s an opportunity to organise well-planned, coordinated care that responds to someone’s needs as they change. A personalised care conversation can take place, enabling people to explore their wishes and preferences for their care both now and in the future.

This EARLY Identification project helps embed advance care planning (ACP). It offers a package of support from a GP Facilitator.

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Addressing inequalities in Palliative Care

SEVERAL PROJECTS ARE UNDERWAY TO EXPLORE AND EMBED PERSONALISED APPROACHES TO IMPROVE PALLIATIVE AND END OF LIFE CARE FOR PEOPLE EXPERIENCING INEQUALITIES IN GREATER MANCHESTER

The projects include working with people from the Learning Disability, LGBTQIA+ and homeless communities investigating various therapeutic methods to help encourage and support conversations, regarding end of life care.
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The aims of the project include:
- Improving the experience of palliative and end of life care for people who experience barriers.
- Enabling the delivery of more person-centred support by developing innovative approaches to conversations around end of life and advance care plans for specific groups of people who may find traditional methods challenging.
Personalised care has a huge contribution to make to reducing health inequalities. It helps people make decisions about managing their health and learns about their priorities. It puts people at the centre of decision making over how they live and how they die.
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The inequalities series supports professionals to think how they can work with groups of people who don’t have equal access to palliative and end of life care services (as identified by the Care Quality Commission’s 2016 report, ‘A Different Ending’).
The 10 groups are people with conditions other than cancer, dementia, a mental health condition, a learning disability, people from black and minority ethnic communities, the travelling community, lesbian gay, bisexual or transgender people, those experiencing homelessness, people in a secure or detained setting, and older people.
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The series supports professionals to:
- improve identification at end of life
- offer Advance Care Planning and personalised care
- improve communication
- address spirituality and cultural needs
The series includes interactive sections and signposts to further reading and resources. It takes around one hour to complete.

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Overview of adult palliative care services

This overview of adult palliative care services is for health and social care staff and was developed in collaboration with Greater Manchester Cancer.

It recognises that each locality has different routes to accessing services, and that availability varies depending on which services are commissioned in each area.

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Dying Matters

Dying Matters is a public awareness campaign about death, dying and grief

Dying Matters is a campaign to break the stigma, challenge preconceptions and normalise public openness around dying and encourage all communities to get talking about death, dying and grief in whatever way works for them.

While Dying Matters is an ongoing campaign, every year people around the country use a specific awareness week. Watch this space to see what Greater Manchester will be doing to both support the campaign and the Dying Matters week.

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Greater Manchester Palliative and End of life Care Dashboard

More information coming soon...

HOMR early Identification in the Acute Setting

This project is piloting the Hospital One-Year Mortality Risk (HOMR) tool across Salford, Wigan and Bolton. HOMR is an application that automatically, accurately and reliably uses admission data routinely collected by hospitals to calculate a patient’s risk of dying within the next 12 months. This helps clinicians identify patients who are admitted to hospital with possible unmet palliative needs.

HOMR is a trigger to improve palliative interventions by focusing attention on patients with a high risk of death and unmet palliative needs, at a key point in their illness.

The programme is assessing how easy HOMR is to use with existing Patient Care Records and how it works within and across different systems.

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EPaCCS and ACP Pilot for People with COPD in the Acute Trust

Coming soon...

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Workforce Development

A Workforce Development programme is being set up to tackle insufficient capacity, recruitment and retention challenges of specialist palliative care staff across the network. A multidisciplinary Workforce Steering Group is exploring a Greater Manchester academy model to support the specialist palliative care nursing workforce.

It will initially focus on specialist medical and nursing staff. Steering group members from across Greater Manchester include: a consultant in palliative medicine, clinical nurse specialists, education leads, and SAS doctors. The project team will include representatives across professions (rather than locality).

Over time, the aim is to build wider specialist multi-professional teams in an innovative solution of blended roles to tackle the capacity required. The benefits of developing the specialist palliative care workforce, using an academy model, would be a reduction in vacancies, a retention of staff already in or working towards a specialist role, and a consistency in a career development programme and skill base across Greater Manchester. In turn, this will help make specialist palliative care services more consistent across the region. For staff who wish to remain on general wards, time in the academy would enhance their skills to take back to their workplace and share, therefore having the additional benefit of skilling up a general workforce.

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