An overview of the Gold Line Supporting care for people in their last year of life

The Gold Line is the helpline featured in our film. Run by nurses, it supports care for people in their last year of life across Airedale, Wharfedale, Craven and Bradford. The support provided by the helpline and the services it coordinates has meant that a significantly higher proportion of people have been able to die in the place of their choosing (usually at home) than the national average. Here we find out a bit more about the Gold Line and the wider programme of work it is part of.

Coordinating end-of-life care

The majority of people in the UK say they would prefer to die at home, but in reality two-thirds end up dying in hospital.

People in their last year of life often need a range of support. Family and carers are not always sure who to contact when issues arise, particularly at night. In some cases, this can mean they call for an ambulance and the person is admitted to hospital, when having the right support in place could have enabled them to remain at home.

The ‘Bringing Healthcare Home’ programme at Airedale NHS Foundation Trust set out to make end-of-life care simpler for people in their last year of life and their carers, and to support people to die in the place of their choosing. There were three parts to the project: developing an electronic system to help health professionals to co-ordinate end-of-life care; training staff to start conversations around death and dying with people in their care; and the Gold Line.

What the Gold Line offers

The Gold Line is a phone line for people who are thought to be in their last year of life and their carers. Senior nurses at Airedale Hospital are available to answer calls 24 hours a day, every day. The nurses provide direct advice and support, and can also contact other services and arrange admissions and home visits as required. As well as telephone support, there are some iPads available, which allow nurses to see people face to face via a secure video link.

Nurses answering calls to the Gold Line have access to patients’ health care records, and can offer practical support – such as around managing pain medication – as well as emotional support. The Gold Line now works with nearly 1,200 people in their last year of life, and the nurses answer more than 500 calls from people each month.

Stephen Lock, whose story is featured in our Gold Line: bringing health care home film, remembers the first time he called the Gold Line when caring for his partner Bea.

‘I first rang Gold Line a couple of days after Bea had come home, just to ask about the drug that she was on. It was a fairly minor little question but it meant that we didn’t need to go anywhere, we just rang one number, we didn’t need to figure out “should I ring the GP, should I ring the pharmacy?”’

A service people value

A team from Airedale looked at how effective the Gold Line is and found that, as a result of calls to the Gold Line, significant numbers of people avoid attending accident and emergency, having to be admitted to hospital, and calling out their GP or community nursing team. Most people would prefer not to die in hospital, and in 2014/15, only 13% of people registered with Gold Line died in hospital (nationally this figure was 58%).

‘There were two things about Gold Line that I think were most impressive,’ says Stephen. ‘One was that, whoever I rang, day or night, knew exactly who we were, knew all about Bea and didn’t seem to need to look it up on any kind of database. As soon as you got through you were talking to somebody who was there to care for you and help you. The other thing is that they were just so incredibly organised. There are about five different services that they co-ordinate but it never feels that way to the person who’s ringing or the person who’s being cared for and that’s difficult to do I think but they do it very, very well.’

The Gold Line is being evaluated and has already seen very positive results, especially from people in their last year of life and their carers. Results of a financial evaluation are expected soon.

More about the Gold Line

How the Gold Line is bringing health care home – an interview with Dr Linda Wilson

Being part of Gold Line is one of the things I’m most proud of in my career – an interview with Ann Wagner

What it’s like to work on the Gold Line?

The Gold Line was funded by The Health Foundation in 2012.