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Benefits and impact

As well as helping people to die on their own terms and in their preferred place, Goldline plays an important role in co-ordinating different parts of the health and care system to ensure they are always focused around the needs of the patient, reducing avoidable admissions to hospital and associated costs, reducing call out rates for GPs and community nursing teams, reducing inequalities in end of life care and improving end of life performance indicators.

Patient and carer feedback

"We just wanted to say thank you for the support you offered during Dad's last few months and weeks of life. You were always kind and supportive when we rang, and sorted things out to get Dad the help he needed, no matter what time of day or night."

"I would not have known who to contact particularly at weekends. Helped me manage at home, absolutely brilliant service."

"The Goldline could not have taken more care if it was their mum. Thank you so much."

"Your advice, support and kindness showed towards our amazing loving dad will never ever be forgotten by our family, and especially myself as I stayed 24/7 with dad in his final days. Without your support this would not have been possible. Dad was in his own home, in his own bed. I/we cannot praise you enough as you are truly amazing."

"The way all the services worked together with you amazed me, with the Goldline seeming to be the hub for all those involved including the GP, District Nurse, Community Care Team and yourselves all consulting with each other. “Joined-up services” at their very best. I wish I could say more apart from I would never be afraid were my own life to end in this way….."

"The Gold Line staff were a life line for myself and family during the final few weeks of my mother’s life. You provided support, advice, reassurance, and above all compassion whenever we dialled the Goldline number. Thank you for your tireless work and support………….It gives peace of mind that someone is on the end of a phone. I used Goldline on numerous occassions and found the support they gave invaluable. The Call Handlers are obviously trained and have a lot of experience. They offer support and give reassurance, whilst managing calls/queries in a professional, compassionate manner. A 5* service."

"…a massive thank you to the staff, from the ladies on the Goldline call centre to the nurses and doctors and hca and every one who was involved with {his} care through his illness what a massive difference you made to him being comfortable and not in any way feel scared or concerned as to what was happening on several occasions we had to ring the Goldine number, and without it we would have been in a very different place. What a great thing it is for people in such situations, and all the staff, we can’t thank enough...they made a tough period in our lives easier to deal with, knowing that you all were there and were always willing to lend not just an ear but also gave top draw advice and help."

Supporting preferred place of death

74% of people referred to Goldline who expressed a preference for place of death achieved this. Deaths in usual place of residence (i.e. home or care home) for Goldline patients is 73% compared to an England average of 47%, meaning patients using Goldline are significantly more likely to die out of hospital.

Only 14% of people on Goldline died in hospital compared to the national figure of 46%.

Place of Death

Goldline

England (March 2018)

Home

38%

23%

Care Home

36%

23%

Hospice

13%

6%

Hospital

14%

46%

Of the three CCG areas using it, AWC has the highest proportion of people registered with Goldline (56% of all deaths and 76% of predictable deaths) at the time of their death, and also the lowest hospital deaths figure in England at 33.4%. The percentage of people dying in hospital in Bradford is also reducing. Goldline registration is a indicator of good anticipatory care planning and this is likely to contribute to some of the best End of Life performance measures in England and Wales, including deaths out of hospital.

Reducing non-elective admission and associated costs

Airedale General Hospital has one of the lowest figures in the country for percentage of people with 3 or more emergency admissions in the last 90 days of life (4.8% vs 6.9% across England. Source: National End of Life Intelligence Network http://www.endoflifecare-intelligence.org.uk/home).

An economic evaluation of Goldline in AWC CCG area was completed by York Health Economics Consortium in 2016. This found a 23% reduction in non-elective admissions for Goldline patients compared to baseline (p<0.00001), equating to a reduction of almost 2000 bed days if scaled up to a caseload of 1000, and cost saving of £440,000. The cost of providing Goldine was £240,000 for a caseload of 1000, generating a return on investment of up to £2 for every £1 spent. The evaluation did not include data on use of community services for these patient groups.

Reducing inequalities in end of life care

Goldline has a reach beyond those referred to specialist palliative care, helping to address some of the known inequality in end of life care support for those with non-cancer diagnosis and/or not known to specialist palliative care services. 58% of the patients referred to Goldline who died during the year had a non-cancer diagnosis and 43% had never been referred to specialist palliative care service.

Benefits

A dedicated 24/7 telephone service for people with a serious illness who are in their last year of life, and the people looking after them. Care is provided by a team of experienced nurses who are on hand to give advice, support and guidance to help people die with dignity in the place of their choosing (usually at home).

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A highly-specialist Health in Justice service providing consultant-led secondary care support via telemedicine to prisoners residing in Prisons and Youth Offender Institutions (YOI) across the country. This service is currently available in more than 30 secure centres across the country.

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The Hub team provides access to advice and support for residents in over 500 residential and nursing homes across the country, as well as individual patients with a variety of long-term conditions. The team has full access to individuals’ care records, allowing them to give comprehensive clinical assessments, guidance on condition management, and ongoing monitoring.

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