Shocked councillor raises concerns after Derbyshire palliative care service is reduced to weekends and bank holidays only

Bolsover District and Town Cllr Donna Hales was disappointed to learn the NHS Derby and Derbyshire Integrated Care Board has altered its commissioning arrangement and withdrawn funding for DHU Healthcare to deliver the Palliative Care Urgent Response Service seven-days-a-week after the board believes alternative care support already exists.

The NHS announced that changes in its palliative care provision for Derbyshire, including the PCURS delivered by DHU Healthcare, came into effect from September 2.

An NHS spokesperson stated: “The Palliative Care Urgent Response Service is no longer funded but DHU Healthcare, with support from Derby [and] Derbyshire Integrated Care Board, will continue the PCURS for patients and families who need urgent intervention at weekends and bank holidays, based on the success of a pilot.”

Labour & Co-operative Cllr Donna Hales said she had been made aware of how good the original DHU Healthcare PCURS had been by an individual who had experienced excellent service from the team and she is disappointed to see the servce reduced so dramatically.

The DHU Healthcare PCURS team including about 30 clinical and support staff had also been crowned with national accolades from the Nursing Times and The Royal College of Nursing after it was launched in 2018.

It provided care and support to patients in need of palliative care as well as for their families and loved ones so patients needing sensitive end-of-life care could die peacefully in their own homes instead of in hospitals after suffering from serious illnesses.

Small mobile vehicle teams with nurses delivered a range of immediate care in patients’ homes including managing symptoms, treatment, prescriptions, and ensuring further on-going care with other health professionals.

DHU Healthcare originally started with a weekend Palliative Care Urgent Response Service across Derbyshire in 2018 and this pilot project was expanded to seven days a week in 2021 successfully supportng a demand and it also operated throughout the COVID-19 pandemic.

A DHU Healthcare spokesperson said: “Our NHS commissioning partners are faced with competing demands in a financially constrained environment and that can mean difficult choices.

“Nevertheless, the decision to return this exceptional service back to weekends and bank holidays has been incredibly disappointing for everyone at DHU, including its Board of Directors who have seen first-hand the difference it makes.”

But the DDICB claims people at end-of-life will still be supported by professional care from doctors, nurses, community teams, and hospices.

The NHS has also stated that for patients at weekends and bank holidays in need of urgent help there will still be two vehicles, one covering North Derbyshire based at Chesterfield, and another covering South Derbyshire, based at Derby, which began operating from September 2, between 8am and 6pm.

It added that DHU Healthcare will also be providing a dedicated palliative triage practitioner as part of the Clinical Navigation Hub during these same times to give advice and support to patients, carers and healthcare professionals via 111 phone line or the Health Care Professional line.

The NHS stated that they will work closely with the PCURS should a home visit from the team be required.

DHU Healthcare stated that the PCURS was “designed to align to the principle of ‘dying-well’” and it has received national recognition for its unique, flexible and specialist approach.

The not-for-profit community organisation added that where possible, the PCURS enables adults and more recently, children and young people, to die in their own surroundings, with their loved ones, if that is their wish.

An NHS Derby and Derbyshire Integrated Care Board spokesperson said: “The Palliative Care Urgent Response Service has provided a high quality of service and has been greatly valued by the families of those who have been supported by DHU Healthcare’s doctors and nurses.

“However, we examined the range of services that are available to support people at the end of their lives and we have found that this service is a duplication of other NHS services.

“We must ensure that our limited resources are used in the most efficient way possible and so we have decided to no longer fund this service.

“The service had been funded through a mixture of one-off funding sources and it was not a formally commissioned service by NHS Derby and Derbyshire ICB or its predecessor organisations.

“People will continue to receive high levels of compassionate and professional care from doctors, nurses and community teams who are funded through other contracts across the NHS and hospice sector.”

A DHU Healthcare spokesperson added: “Our teams continue to care with commitment and compassion – providing a high-quality service to individuals and families during their most challenging moments.

“We are collaborating with our NHS partners – working together to keep demand, care needs and outcomes under review and to ensure patients and families are not negatively impacted by this change.”