The seminar (watch a recording) was chaired by Ruth Hutt, Director of Public Health at Lambeth Council. In her introduction, Ruth outlined the health and care challenges and priorities in Lambeth, including highlighting a four-year difference in life expectancy between the most socioeconomically deprived ward in Lambeth and the least deprived.

We know that the social determinants of health, things like housing quality, poverty, poor air quality, education, as well as structural racism, which is very much part of the landscape of health inequalities in this country and relates to access to services, play a part in this

Ruth Hutt, Director of Public Health at Lambeth Council

Ruth then described some of work that the council are doing to address these wider determinants of health, including through the new NIHR-funded Lambeth HEART research programme.

After this, there were two presentations highlighting examples of research designed to improve care for children and young people and older people with advanced illness.

Improving care for children and young people in Lambeth and Southwark

The first presentation was on CHILDS: an evidenced-based population health management approach to child health care, with Dr Ingrid Wolfe, director of the Children and Young People’s Health Partnership (CYPHP) and Dr Lucy Pickard, consultant paediatrician, King’s College Hospital.

They described how ARC researchers have implemented and evaluated a new programme that is improving the way health care is delivered for children and young people living in Southwark and Lambeth. The new model of care, developed in partnership with parents, children and health professionals, is designed to ensure children and families who need support are identified earlier. The model is also designed to ensure that everyday health conditions, such as asthma and eczema, are managed better and families can access care closer to home, rather than going to hospital.

Dr Wolfe and Dr Pickard outlined some of the positive outcomes that stem from this approach. Children and young people who received specialist nursing to support with asthma, eczema and constipation through the programme, saw significant improvements with their conditions.  

  • Asthma: 90% of patients who had uncontrolled asthma at their initial assessment were discharged with reasonably or well controlled asthma, when treatment was completed
  • Eczema: 96% of patients had a clinically significant improvement on discharge
  • Constipation: 85% of children with constipation levels above threshold when they enter the service, and after 6-10 weeks only 38% still have symptoms above threshold

There were also significant benefits in terms of health service use, with fewer families needing to visit A&E.

Strengthening integrated palliative care in care homes

The second presentation was on ‘Bringing care closer to ‘home’: Strengthening integrated palliative care in care homes’ with Dr Anna Bone, lecturer in epidemiology and palliative care, and Professor Catherine Evans, professor of palliative care, both King’s College London.

The researchers discussed how palliative and end of life care researchers based at the Cicely Saunders Institute have developed new models of integrated community-based care to improve quality of life for care home residents with advanced illness.

Dr Bone described how care homes are increasingly important providers of end of life care.

Some work we did a few years ago found that care home deaths are increasing and when you combine this with our changing demographics and ageing population, if those trends continue care homes could become the most common place to die by 2040. We know that up to 50% of care home residents are in their last year of life and yet there is still sub-optimal care towards the end of life in these settings

Dr Anna Bone, lecturer in epidemiology and palliative care, King’s College London

Among care home residents, researchers identified more complex health needs and higher unplanned hospital admittance at the end of life. The team tried to understand some of the factors that led to more unplanned visits to hospital and made a series of recommendations to address these factors, including the need to value the work of care homes and staff.