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Six Steps+. End of Life Care Programme for Care Homes

Angela Springett, Practice Educator, St Wilfrid's Hospice, Chichester, West Sussex

Angela's case study was completed in October 2015 and reflects 2015 prices

If care home staff are to confidently manage patients with complex needs at the end of life, it is important they are supported with the right skills and information. Using the Six Steps+ programme to build the competence and confidence of care home staff, Angela Springett, practice educator at St Wilfrid's Hospice in West Sussex, wanted to demonstrate to her commissioners the value of her intervention.

The programme focuses on six key areas: discussions at end of life; holistic assessment of the patient; the coordination of care; delivery of high quality care; care in the last days of life and care after death. Angela’s approach was to develop and accredit two End of Life Champions in ten care homes in the St Wilfrid’s Hospice catchment area of Chichester, Bognor Regis and the Manhood Peninsula. In turn, with managerial support, the accredited Champions implemented the Six Step+ principles within their care setting, educated the rest of the care home staff, and produced evidence to support this in the form of organisational and individual portfolios.

Angela wanted to demonstrate the economic value of her approach and looked at the costs avoided by enabling care home residents to spend their last days and end their lives in their place of choice, their care home, rather than be admitted to hospital.

Angela demonstrated that her intervention benefits patients, the standing of the care homes, and the wider health and social care economy. Her analysis illustrates that the avoidance of 6 hospital admissions covered the cost of the Six Steps Programme, making it cost neutral to potential commissioners. Any further reduction in admissions would result in further cost avoidance and potential financial savings, making a strong case for the programme to be introduced more widely.

You can email Angela at

One page summary

Presentation from a breakfast event, Demonstrating the value of nurse-led innovations in End of Life Care, which took place on 27 April 2016

End of Life Care

Watch the video of the breakfast event, Demonstrating the value of nurse-led innovations in End of Life Care, which took place on 27 April 2016