Macmillan Cancer Support has a long history of working collaboratively with local authorities across England on end of life and palliative care and this collaboration has taken different forms. This case study forms part of our end of life care guide for councils.
In Barnsley, South Yorkshire, a Macmillan Social Worker is employed by Barnsley Council to sit within the multidisciplinary team of clinical nurse specialists, occupational therapists and dieticians to provide expert support for people in need of complex palliative care and support at end of life.
This role, managed by the council, works across the whole council area and is predominately there to help unpick the issues people are facing and help them access appropriate support throughout their care pathway.
What does this role involve?
This holistic support has helped to embed personalised and individualised end of life care, with the specialist social worker having considerable involvement with the following:
- Advance care planning conversations with patients, working to have these at the most appropriate time in a patient care pathway. This supports early identification of patient need and shared decision making in meeting end of life care needs.
- Supporting patients adjust and manage the distress they are experiencing due to changes in their illness – linking in with occupational therapists and social services to assist when patients’ needs change due to deterioration.
- Helping patients to manage their finances by signposting them to appropriate advice and support on leaving work, securing benefit entitlements, as well as dealing with mortgages and insurance.
- Integrating and co-ordinating care - linking with local hospices and hospitals to develop a more seamless pathway of care.
Wider family unit
- The specialist social worker also spends a huge amount of time supporting carers to manage the dynamics of their relationship with their loved one so that they can continue to provide care at home. This is supported through working with carers, a local college and nursey staff.
- Likewise, they also provide vital support to young people, helping parents to be able to talk to their children about what’s happening and providing age appropriate information. The role provides an important function in supporting vulnerable young people who may not recognise that they are carers, accessing community support to build up a network around them, and ensuring support is in place at school.
Impact of the role
- The role has allowed for more patient centred end of life care targeted at meeting the needs of patients, and their loved ones resulting in more efficient care. Although it is difficult to quantify impact, we know from speaking to professionals in the service that the role of supporting carers is likely to have reduced the numbers of emergency admissions to hospital through giving people the confidence, they need to support people at home.
- The work the social worker has done around bereavement preparation for carers, including those who have dealt with multiple close family deaths, has also had an impact on the fear about conditions such as cancer and has helped people to feel more confident about talking about death and dying. This has improved the mental and emotional resilience of the community.
Impact of the partnership
- The Macmillan partnership with the council has had a broader positive effect that just the role itself. The specialist social worker has initiated a Social Care Champions Group to promote specialist palliative care across the borough, with meetings every two months to share best practice.
- As part of this the Macmillan social worker supported specialist palliative care education across other social care teams within the local authority with opportunities to pursue QCF qualifications in EOL care, advanced communication skills and attend a foundation course open to social care professionals across the borough.
- Due to the success of these education initiatives a champion is now provided in each area who has an additional knowledge base to support their own social care area teams as well as developing their own special interest. In the words of a Macmillan professional “they are a motivated and passionate group”. There is also a standardised care plan used across the borough for those in the last days of life, teams are more connected across social care and increasingly there is a recognised common language used for end of life and palliative care.