"I live in a community where everybody recognises that we all have a role to play in supporting each other in times of crisis and loss. People are ready, willing, and confident to have conversations about living and dying well and to support each other in emotional and practical ways."

What the citizens of Lancashire and South Cumbria say this means for them

"I feel like my community cares about me and my family."

"This is a great ambition to work towards. Supporting each other and everyone involved in the end-of-life care. Honest and open conversations can be difficult but having people you can approach in the community would be great."

"Encouraging people in communities to talk about death, to plan and to prepare. Involving funeral directors and others in the community who are often involved around death and dying (clerics, publicans etc.)"

"Death is the only experience we will all share so encouraging planning, talking about and knowing about our loved ones wishes can reduce so much anguish and anxiety for all."

Lancashire and South Cumbria commitments towards making this happen

• We will build end of life care capacity by developing and nourishing compassionate communities
• We will support the public to have more informed and confident discussions around dying, death and bereavement
• We will ensure practical support, information and training on end of life matters is accessible and relevant to those that need it by working closer with families, neighbours and the community
• We will coordinate the recruitment, connecting and training of volunteers so that their contribution and value can be best utilised
• We will ensure that people know what support they can access from their community

Enablers and responsibilities

Enabler

• Compassionate communities - awareness and promotion with the public, dedicated approach and resources to building and maximising the use of community assets, volunteer led models of end of life care and bereavement support.
• Public conversations and future life planning - e.g. ongoing public engagement around future life planning, platforms and resources to support members of the public to think about, talk about, record, and share what is important to them.
• Public health campaigns - e.g., local approaches to National Dying Matters and National Grief Week where all organisations, members of the public and businesses and encouraged to participate, social media is used to communicate public health messages far and wide, joint working with population health and public health to support messaging e.g. organ donation.
• Public/patient representatives - active engagement within palliative and end of life strategic and operational groups across the locality.
• Social prescribing - e.g. social prescribers are trained to be knowledgeable, skilled, and confident to recognise and signpost to palliative and end of life care support and services.
• Informal caregivers - carers of people with palliative and end of life care needs are recognised, education and support packages are available, they have access to bereavement support, collaborations with VCFSE sector.
• VCFSE groups - active and frequent engagement with the VCFSE sector to plan, implement and evaluate palliative, end of life care and bereavement services including services to carers.

Commissioner Levers

• Underpinning guidance detailed on page 11-4
• NHS Continuing Health Care fast-track pathway 18
• Universal Principles for Advance Care Planning 7
• NHS Virtual ward guidance 19
• NHS Chaplaincy guidance 20
• Clinical Leadership and peer leadership throughout ICS, ICP and place-based partnerships
• Joint strategic needs assessment
• The Well Pathway- Dementia Care 22
• Dying Well in Custody Charter 23
• Care committed to me 24
• UK Commission on Bereavement 26
• Standard KPI’s across provider contracts
•  Primary care contracts
• Care home contracts
• Community service contracts
• Hospital contracts
• Hospice (Including children’s hospice) grants
• 3rd sector contracts/grants
• VCFSE grants
• Domiciliary care contracts
• Lead/joint provider contracts
• Children’s and Young Peoples service contracts

Provider Levers

• Named clinical and board executive lead
• Organisational palliative and end of life care strategy
• Place based partnership groups
• Annual audits
• Incident reviews
• Job roles and responsibilities
• Education and training
• Joint working with social care
• Joint working with VCFSE groups
• Dying Matters
• Universal Principles for Advance Care Planning 7
• The Well Pathway- Dementia Care 22
• Dying Well in Custody Charter 23
• Care committed to me 24

Measurements of success

• Number of active compassionate communities e.g. measured by number of volunteers or volunteer-led activities over period of time
• Number of active VCFSE partnerships involved in end-of-life care
• Number of people accessing Future Life Planning education
• Improved carer wellbeing
• Survey of service users and bereaved people (consider place or ICS wide approach)
• Patient case studies
• Number of providers adopting a compassionate communities’ approach
• Annual Dying Matters campaign that is coordinated cross boundary.

NB: Baseline measurements should consider skewed data arising due to COVID-19.

Best practice examples

Primary Care Network support to develop local bereavement groups

Scope of coverage: Fylde Coast

Lead contact: Janet Walsh janet.walsh7@nhs.net

Brief description: Two of our local Primary Care Networks (PCNs) requested our support for developing local neighbourhood bereavement support services. Recognition of the significant increase in need for bereavement support as a result of the pandemic. Seen as an opportunity to address unmet need and current long waiting lists for the Linden Centre adult service and opportunity to build collaborative working with PCN partners.

• To train, support and enable two sets of PCN staff to develop and sustain their own local community bereavement support groups.
• To help PCN staff to recognise and support normal patterns of grief as well as those with red flags, who may need referral for more specialist support.
• To reach out further into our local communities to raise awareness of Trinity services and resources.
• To enable support for more people living with grief and bereavement in our local neighbourhoods promoting compassionate, resilient communities.

Outcomes: Two half days training were delivered to staff from Torentum and LSA PCNs. 11 staff attended and delivery was via Teams. The feedback from the sessions was excellent and participants found it useful. Both PCNs are now running bereavement support groups which are going well. We have also offered, as needed ongoing support/ information.

EOLP compassionate communities team - Cheshire

Scope of coverage: Cheshire East & Cheshire West place

Lead contact: Catherine Morgan-Jones Catherine.Morgan-Jones@eolp.org.uk

Brief description: Prospectus for Public Health training sessions (eolp.co.uk) Helping communities to build their networks and resources to meet the needs of local people. Working across Cheshire covering topics that are based on individual community needs, to support people and their families, who are dying or living with loss. Complimenting local services allowing resources to be used efficiently. Developing communities’ knowledge, skills and confidence through a variety of training sessions for a wide ranging audience, such as staff, volunteers, carers and members of the public.

Outcomes: Feedback has shown that those who attend our sessions benefit greatly, in being able to support others through times of crisis such as loss, grief and bereavement, supporting carers through their caring journey and planning for the future.