HSC Core Bereavement Network Team

Management Plan and Quarterly Reporting Framework

1 April 2016 to 31 March 2017

Record of actions that contribute to implementation of the HSC Services Strategy for Bereavement Care (2009) towards improving the experience of bereaved people

Draft Quarter 3Report – for approval

HSC Services Strategy for Bereavement Care (2009) Standards

Standard 1: RAISING AWARENESS

That Health and Social Care staff will be suitably trained to have an awareness and understanding of death, dying and bereavement. Staff should also acknowledge the fact that grief is a normal process following loss, and that needs vary according to an individual’s background, community, beliefs, and abilities.

Standard 2: PROMOTING SAFE AND EFFECTIVE CARE

That all Health and Social Care staff who have contact with people who are dying and/or those affected by bereavement will deliver high quality, safe, sensitive and effective care before, at the time of and after death according to individuals’ backgrounds, communities, beliefs and abilities.

Standard 3: COMMUNICATION INFORMATION AND RESOURCES

That people who are dying and those who are affected by bereavement will have access to up to date, timely, accurate and consistent information in a format and language which will be helpful to their particular circumstances and consistent with their needs, abilities and preferences. Staff will remember that the availability of written or other information does not negate their personal support role.

Standard 4: CREATING A SUPPORTIVE EXPERIENCE

That those who are dying and their families will be afforded time, privacy, dignity and respect and, wherever possible, given the opportunity to die in their preferred environment with access to practical, emotional and spiritual support based on their individual needs and preferences.

Standard 5: KNOWLEDGE AND SKILLS

That Health and Social Care organisations recognise the value of a skilled workforce by ensuring that those coming into contact with, or caring for people who are dying and those affected by bereavement are competent to deliver care through continuing professional development; and by having systems in place to support them.

Standard 6: WORKING TOGETHER

That good communication and co-ordination will take place within and between individuals, organisations and sectors, to ensure that resources are targeted efficiently and effectively and that there is integration of care to meet the needs of people who are dying and their families, friends and carers.

Regional Projects to be Delivered/completed in 2016-17
  • Implementation of recommendations from re-audit project – Dying, Death and Bereavement, a re-audit of HSC Trusts progress to meet recommendations to improve policies, procedures and practices when death occurs
  • Consultation and introduction of ‘last offices’ guideline
  • Trigger bereavement experience review in partnership with ‘10,000 Voices’

On-going standard Implementation and Strategy focused activity supported by TBC’s/standing items on monthly meeting agenda
  • Staff initiatives – education and training, support
  • Patient and Family initiatives – resource development, contact from public, SAI/complaint activity
  • Governance initiatives – maintaining Trust Bereavement Forums, contributing to policy/procedure reviews, Maintenance of HSC Bereavement Network website
  • Network contribution to regional, national, international initiatives – interagency working groups, contact with community/voluntary bereavement support services, promotion of HSCBN vision and objectives

Progress Key: / Action not planned to commence /  / Serious risk of non-achievement /  / Slight delay /  / Completed/ongoing work to meet standard
Implementation of recommendations from re-audit project – Dying, Death and Bereavement, a re-audit of HSC Trusts progress to meet recommendations to improve policies, procedures and practices when death occurs
This project contributes to the following standards / Standard 1: RAISING AWARENESS
Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 3: COMMUNICATION INFORMATION AND RESOURCEs / Standard 5: KNOWLEDGE AND SKILLS
Standard 6: WORKING TOGETHER
Standard 4: CREATING A SUPPORTIVE EXPERIENCE
Project Outline and Timeframe / Quarterly Progress / Actions/Outcomes
Recommendations implementation
Dying, Death and Bereavement: a re-audit of HSC trusts progress to meet recommendations to improve policies, procedures and practices when death occurs
Audit report submitted to GAIN March 2016
Due release 9th May after local elections
Project lead
Gwyneth Peden
Anne Coyle / Date
Started
Report released13 May 2016 / Date
Complete / 1 /  /
  • GAIN released report on 13th May - 100 copies published and shared among TBCs
  • Team received positive feedback from GAIN/RQIA on quality of report
  • Action plan for audit implementation tabled/agreed at HSCBN meeting 22 June
  • Project Closure Form submitted to GAIN
  • Dissemination/ Implementation events planned in all Trusts

2 /  /
  • TBCs working with their Trust Bereavement Forum chairs to plan workshops with members to agree local action plans to meet audit recommendations
  • Team invited by GAIN to submit an abstract to present the re-audit at their Annual Health and Social Care Quality Awards on 30th November.

3 /  /
  • Audit presented at GAIN Awards on 30th November
  • Rec 1 - review of Bereavement Strategy underway

4
Consultation and introduction of last offices- care after death guideline for nurses and care assistants
This project contributes to the following standards: / Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 3: COMMUNICATION INFORMATION AND RESOURCES / Standard 4: CREATING A SUPPORTIVE EXPERIENCE
Standard 5: KNOWLEDGE AND SKILLS
Project Outline and Timeframe / Quarterly Progress / Actions/Outcomes
Commence project In partnership with the Chief Nursing Officer, Directors of Nursing in HSC Trusts etc., to trigger a review of last offices practices in NI and subsequent development of up to date guidance to inform policy and practice
Project Lead
Paul McCloskey / Date
Started
Nov 2014 / Date
Complete / 1 /  /
  • Consultation with Nurses and Care assistants on draft ‘care after death- last offices’ guidance opened on 13 April with letters to Directors of Nursing. Closing date for responses 27May. Responses collated and returned to Paul by 10th June

2 /  /
  • Post consultation draft completed 30th September for approval of HSCBN prior to return to CNO for ratification/circulation

3 /  /
  • Additions agreed at HSCBN meeting 26th October
  • Final Draft circulated to Network for approval 6th December

4
Trigger bereavement experience review in partnership with ‘10,000 Voices
This project contributes to the following standards / Standard 1: RAISING AWARENESS
Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 3: COMMUNICATION INFORMATION AND RESOURCEs / Standard 5: KNOWLEDGE AND SKILLS
Standard 6: WORKING TOGETHER
Standard 4: CREATING A SUPPORTIVE EXPERIENCE
Project Outline and Timeframe / Quarterly Progress / Actions/Outcomes
Re- audit phase 2 Dying Death and Bereavement - the experience of bereaved people in partnership with 10000 Voice project / 1 /  /
  • 11May: 10,000 Voices Project Board approved working in partnership with HSCBN to capture stories from bereaved people
  • 31May: Christine Armstrong attended TBC meeting to discuss project initiation. Steering group happy to support a 10000 Voices project with TBCs. Project planning to commence January 2017
  • WHSCT: 8/6/16 Meeting with Western Trust 10,000 voices coordinator to update

2 /  / Project Commencing Q4
3 /  /
  • Christine Armstrong, 10,000 Voices Coordinator attending TBC meeting on 28th February 2017 to go over details about the pilot

4

Standard Implementation Actions supported by TBC’s

Staff focused actions – Education, Training, Support
These actions contribute to the following standards: / Standard 1: RAISING AWARENESS
Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 3: COMMUNICATION INFORMATION AND RESOURCES / Standard 4: CREATING A SUPPORTIVE EXPERIENCE
Standard 5: KNOWLEDGE AND SKILLS
Standard 6: WORKING TOGETHER
Ongoing Activity / Quarterly Progress / Actions/Outcomes
Education and Training
PM Consent training programme and monitoring of uptake / 1 /  / SHSCT: Part 2 - CAH 15 April/ DHH 27 March.
E-learning – improved figures for uptake.
BHSCT:Regular slots in RJMS for part 2 training
SLA with other Trusts being developed as all PMs now take place in BHSCT
2 /  / SHSCT: Part 2 updates provided post induction to OBGYN, Paediatric and Medical teams. E-learning module being migrated to HSC leadership centre on 3rd October. To be monitored for impact on uptake
  • E-learning uptake discussed at TBC meeting on 27th September. TBCs to speak to medical directors re poor uptake of training programme and trigger communication to medical staff
WHSCT Part 2 delivered to x3 groups of midwives and Maternity Support Workers in Altnagelvin & South West Acute Hospitals
BHSCT: Part 2 training dates ongoing in RJMS
3 /  /
  • Audit of consent forms and training uptake by each Trust requested at HSCBN meeting on 26th October for next meeting on 18th January 2017
BHSCT :Part 2 training at RJMS audit meetings
NHSCT: Part 2 training at obs and gynae medical staff teaching or audit and governance meetings each site
SEHSCT: PM Consent eLearning training uptake reviewed as part of GAIN implementation programme
WHSCT:16/11/16 Stage 2 presentation at OBGYN doctors training session. Midwives also in attendance. 28/11/16 Stage 2 presentation at Midwifery Matters Training Day, SWAH
4
TBC led or TBC supported in-service provision / 1 /  / SHSCT
  • Miscarriage management update for Gynae, Theatre and ED nurses 25 May, 6, 7, 14 June
  • Bereavement Care update– 10 May, 6 and 30 June. Bespoke session DNs 8 June, Cancer Services 27 June
WHSCT
21/4/16Sudden Infant Death in EDinput to CEC courseCare of a Child in ED. 26/4/16Input to CEC coursePalliative Care Awareness for RN’s, SWAH. 20/5/16 Full day CEC course Loss Grief and Bereavement / Communication Skills for RN’s. 20 & 27/4/16 Co-facilitation Final Journeys training, TCH and AAH. 24/5/16 Input to CEC Dementia Nurses courseLoss Grief and Bereavement. 3/6/16 Band 5 Nurse induction, AAH
BHSCT
  • Nurse Induction 14 April, HCA Induction 31 May & 1 June
  • Role of nurse after death RVH ED, 5E, Cardiology & BCH ongoing
  • Breaking Bad News Work experience programme 27 June
SEHSCT
  • HCA Training Induction Programme n 04/05/16
  • Nurse Induction Grief and Bereavement Training 05/05/16 04/06/16 07/07/16
  • Dying Matters Big Conversation Presentation 10/06/16
  • Presentation of Research findings to NIHCCA, Seagoe Parish Centre 11/06/16
  • BBN presentation, F1 and F2s 13/06/16
  • Caring at the EoL training Domiciliary Care Staff, 16/07/16

2 /  / SHSCT
  • Monthly death and Bereavement update ongoing
  • Bespoke updates provided for ICU, Dieticians, NVQ facilitators and Bluestone teams
  • Medical staff induction sessions July and August
NHSCT
  • HCA mandatory update programme 4&6/10/16
  • RN/RM Induction programme 4/10/16
WHSCT Band 5 Nurse Induction 2/9/16
SEHSCT
  • Nursing & Midwifery Induction
    7 Jun 2016 27 attended
  • Domiciliary Care Workers, End of Life Training
  • Junior Doctors Induction, Downe
    3 August 2016 10 attended
  • Nursing & Midwifery Induction
    9 August 2016 27 attended
  • Last Offices and Bereavement Care Training, Ward 12 Staff
    11 August 2016 4 attended
  • Last Offices and Bereavement Care Training, Ward 12 Staff
    18 August 20016 9 attended
BHSCT
  • Nursing & Midwifery Induction
  • Rolling programme of training on Nurses Role after Death
  • Just been given a slot on monthly mandatory training
  • Invitations to speak at audit meetings

3 /  / SHSCT
  • Monthly death and Bereavement update ongoing
  • Bespoke updates provided for Blossom Surestart, Children and Young Peoples M&M, Dungannon ICT, Trust Memory Services teams
  • Trust General Nurse and Paediatric Nurse Induction
BHSCT
  • Ongoing Nurse Role after Death presentations
  • Nurse and HCA Induction
  • Nurse Role after Death at monthly mandatory nurse training
  • Training on request from service groups
NHSCT
  • Two paediatric mandatory training slots,
  • HCA mandatory training and HCA Induction.
  • Dealing with distressed and grieving relatives for RNs
  • Grief and Bereavement awareness session to Practice Nurses at ‘MacMillan Cancer Support Course’
SEHSCT
  • Introduction of waterlily symbol across clinical areas in the Trust
  • Bereavement Care Training delivered to as part of F1 and F2 programme.
  • GAIN implementation workshop held on the 16 December 2016
  • Ongoing grief and bereavement awareness sessions held for nursing and midwifery staff
WHSCT:
  • 27/10/10 Bereavement Care input to CEC Palliative Care Awareness for RN’s
  • 8/11/16 Band 5 nurse induction, SWAH
  • 15/11/16 Bereavement Care and Self-Care presentation, WHSCT Critical Care Conference, Altnagelvin
  • 28/11/16 Band 5 nurse induction Altnagelvin Hospital
  • 28/11/16 Bereavement Care and Communication for Midwives, Midwifery Matters training day, SWAH
  • 7/12/16 Co-facilitated Bereavement Care in Adult Nursing; full day CEC course, Altnagelvin
  • 8/12/16 Band 5 Nurse Induction, Altnagelvin
  • 15 /12/16 Band 5 Nurse Induction, SWAH

4
Liaison with education providers to contribute to the development of accessible training programmes for healthcare staff ensuring content reflects the HSC strategy and standards for bereavement. / 1 /  /
  • CEC – request for TBC guidance/steer on content of bereavement care study days. TBC input in delivering study day content 13 April, 17 June
  • WHSCT – working with Trust practice development midwife to design bereavement awareness course for HCA’s and Maternity Support Workers.

2 /  /
  • CEC - Team continue to support requests to present on study days
  • QUB – Date for presentations on Year 1 and 3 nursing programme confirmed. Awaiting Year 2 dates
  • UU Magee Campus - 2nd year nursing programme lecture 4/10/16
  • Request from Belfast Met to present to health and social care students on 27 October

3 /  /
  • UU, Magee Campus 2x 1st year lectures 30/11/16

4
Staff Support
Contribute to initiatives that provide support systems for HSC staff / 1 /  /
  • All TBCs reporting contact from staff for advice/support which they record and discuss at TBC meetings
  • Services remembering deceased staff held in SET 26 May and BHSCT 6 June
  • WHSCT – reflective sessions provided on request of staff / managers after traumatic death / incident:
13/4/16 ICU staff; 29/4/16 learning disability day centre staff
2 /  /
  • All TBCs reporting contact from staff for advice/support which they record and discuss at TBC meetings

3 /  /
  • All TBCs reporting contact from staff for advice/support which they record and discuss at TBC meetings
BHSCT: Bereavement Link Nurses identified in all wards, bi-monthly bereavement newsletter, debriefs as requested
NHSCT:Trust Psychological Health and Wellbeing group – now have staff bereavement work stream TBC joining group to contribute
WHSCT Meetings with neurology consultant and next of kin re planning for potential patient brain donation; support of next of kin and transfer arrangements input from Brian Herron, Neuropathologist, BHSCT.
6/11/16 – planning and attendance at critical care service of remembrance, Altnagelvin Hospital
8/1/16 Staff support reflective session delivered in Critical Care after difficult incident
14/12/16 Presentation at Trust Governance committee of excellent example of bereavement care in practice within Gynae Ward, Altnagelvin. Team now nominated for Trust Midwifery & Nursing award.
4
Patient and Family
These actions contribute to the following standards: / Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 3: COMMUNICATION INFORMATION AND RESOURCES / Standard 4: CREATING A SUPPORTIVE EXPERIENCE
Standard 6: WORKING TOGETHER
Ongoing Activity / Quarterly Progress / Activity/Outcomes
Resource Development / 1 /  /
  • ‘When someone dies’ a resource for people with learning disability and their carers developed by NHSCT. Permission given to badge this with HSCBN logo for use in all trusts. Available from website and hard copies printed for TBCs to distribute

2 /  /
  • SEHSCT - Water lily symbol launched in Trust over last couple of weeks.
  • WHSCT - Bereavement Suite approved, architect appointed, plans approved
  • SHSCT – pilot of HFH symbol undertaken over summer in non-acute hospitals. Provision of bereavement booklet adopted as a Patient Client Experience Quality indicator in Acute. Experience and view of booklet content to be measured via a survey in each booklet

3 /  /
  • BHSCT – sympathy cards sent to families after 1 month with invitation to make contact if necessary
  • WHSCT: 14/11/16 focus group facilitated of bereaved parents to give input to design of new bereavement suite. Very positive feedback. Facility to be called the Lavender Suite.
Contact with LD consultant re use of bereavement booklets for Learning Disability.
Meeting with head of service to review roll out of bereavement pathways within maternity department.
4
Contact with the public / 1 /  /
  • TBCs continue to record contact from the public at trust level and discuss at TBC meetings

2 /  /
  • TBCs continue to record contact from the public at trust level and discuss at TBC meetings

3 /  /
  • TBCs continue to record contact from the public at trust level and discuss at TBC meetings

4
Record of SAI/Complaint activity / 1 /  /
  • Requests for TBC advice or support for staff/ families related to complaints and SAI processes discussed and recorded at monthly meetings

2 /  /
  • Requests for TBC advice or support for staff/ families related to complaints and SAI processes discussed and recorded at monthly meetings

3 /  /
  • Requests for TBC advice or support for staff/ families related to complaints and SAI processes discussed and recorded at monthly meetings

4
Governance
These actions contribute to the following standards: / Standard 2: PROMOTING SAFE AND EFFECTIVE CARE
Standard 5: KNOWLEDGE AND SKILLS
Standard 6: WORKING TOGETHER
Ongoing Activity / Quarterly Progress / Activity/Outcomes
Monitor DHSSPS/PHA/HSC directives, reports and inquiries in relation to death and bereavement and take action as appropriate / 1 /  / DHSSPS request to team - review 4th edition SANDS guidance for professionals on miscarriage, stillbirth, neonatal death. Feedback provided to David Best 13 May
2 /  / Regional M&M review - Paul asked to be involved in developing job description and selection process for M&M process coordinator in SET
PHA letter re regional guidance on management of early pregnancy loss up to 12 weeks gestation – issued to Trusts etc. on 6th July.
3 /  / DOH- David Best informed team about the commencement of the pilot of the regional M&M system from 14/11/16 which includes the facility to complete an electronic version of the MCCD.
4
Maintenance of Bereavement Fora in all 5 Trusts to facilitate standard implementation / 1 /  / SHSCT – Forum workshop held 29 April
WHSCT – Forum meeting9 June 2016. Workshop planned for 13 October 2016
BHSCT – Adult Forum 12 April, Children’s Forum 3 May, Maternity Forum 5 May, Forum Workshop 2 June
SEHSCT- Bereavement Forum 21/05/16 next meeting 22/07/16
2 /  / SHSCT- June meeting cancelled to facilitate briefing of new chair. Next meeting 26th October