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Advance Care Planning for older people with Frailty: The Solihull Approach
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Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Apr 16, 2017

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Page 1: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Advance Care Planning for older 

people with Frailty: The 

Solihull Approach 

Page 2: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?
Page 3: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

https://youtu.be/saUE00lUNZw

Page 4: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Get in Early

Choose to Admit

Specialist Acute Care

Discharge 2 Assess

Recovery Before 

Placement

Every Moment Counts

Priority Programme for Frailty Transformation :Cutting the costs of Frailty

Compassionate CareTechnology Enabled CareMental Health and DementiaOrthogeriatrics, falls and Surgical LiaisonCarersCommunity Activation

Page 5: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Get In Early

We will develop systematic approaches to identifying these risks in people aged 75 and above and mobilise a response based on the priorities of the older person 

and their families.

Page 6: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Choose to Admit

We will develop emergency response systems to identifying people with a frailty crisis and build 

capacity and responsiveness for the provision of safe, effective services in people's homes or in step up intermediate care beds as an alternative to acute 

hospital admission. 

Page 7: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Specialised Acute Care

We will ensure that frail older people in acute settings are identified during emergency response or after surgical intervention, with early involvement of old 

age specialist teams.

Page 8: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Discharge to Assess

We will develop the capacity and responsiveness of community based post acute‐care services to ensure that older people can be transferred quickly with simple triage to post‐acute settings, with 48 hour follow‐up by advanced care practitioners to reset 

post‐acute care plans.

Page 9: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Recovery before Placement

We will develop systems to ensure that all older people recovering from a frailty crisis have access to up to six weeks of rehabilitation and re ablement prior 

to the provision of long term support services.

Page 10: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Every Moment Counts

We will provide an opportunity for all frail older people and their families who receive our services to 

develop anticipatory care plans for their future treatment options.

Page 11: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Advance Care Planning

Page 12: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

What We Want To See

Page 13: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Death Happens‐ Live With It

• Get in early• Together is 

better• What matters 

to me is everyone’s business

Page 14: Transforming End of Life Care in Acute Hospitals - Plenary 3 - The Solihull approach to Advance Care Planning for older people with frailty, a model for end of life care?

Thank you for 

listening