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Specialist Palliative Care Services at HEYT. Dr Kirsten Saharia Dr Elaine Boland Consultants in Palliative Medicine. Definition. Palliative care is the active, holistic care of patients with advanced progressive illness
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Specialist Palliative Care Services at HEYT Dr Kirsten Saharia Dr Elaine Boland Consultants in Palliative Medicine
Definition • Palliative care is the active, holistic care of patients with advanced progressive illness • Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount WHO definition, 1990
Palliative care Is multiprofessional Affirms life and regards death as a normal process Neither hastens nor postpones death Provides relief from pain and other distressing symptoms Integrates the psychological and spiritual aspects of patient care
Palliative care Offers a support system to help patients live as actively as possible until death Offers a support system to help the family cope during the patient’s illness and in their own bereavement
Hospice Community Palliative Care Team Hospital Palliative Care Team Specialist Palliative Care Services
Specialist Palliative Care Services • 2008 • 1 Consultant (0.8 WTE) • 4 CNS (4 WTE) • Inpatient specialist palliative care beds • Now • 4 Consultants (2.05 WTE) • 6 CNS (5 WTE) • No inpatient specialist palliative care beds • Excellent access to specialist palliative care beds at local hospice
Hospital Palliative Care Team • Consultants: • Dr Kirsten Saharia (0.55wte HEYT + 0.3wte Hospice) • Dr Hannah Leahy (0.6wte) • Dr Elaine Boland (0.9wte) • Dr Rachael Dixon (0.8wte Hospice + 0.2wte HEYT)
Hospital Palliative Care Team • 6 Clinical Nurse Specialists (5wte) • Jane Prutton • Steve Morris • Maggie Simkiss • Debbie Marsh • Gill Moy • Leanne Joseph • 1 MDT administrator (part –time) • Liz Lawson
The role of the Specialist Palliative Care Team in Hospital • Joint working with other specialist teams • Management for complex symptoms & ethical dilemmas • All patients discussed in SPC MDT • Promote advance care planning • Support implementation of end of life care strategy • Education • Clinical governance
Advisory Role • Any patient, anywhere in the acute trust • For any patient with life-limiting, advanced progressive disease • Physical symptoms • Psychological issues • Social and family issues • Spiritual issues
SPC Outpatient Clinics • Consultant led • Urgent pain and symptom management • Tuesday afternoon, Thursday and Friday mornings • Held in oncology outpatients • Anyone can refer • Offer educational opportunities
Communication skills Symptom management End of life care Principles of palliative care Ethics Undergraduates Medical Nursing Postgraduates Medical Nursing Allied health professionals Auxillary staff Education
Clinical Governance • Patient safety • Audit • Guidelines • Peer review measures • Engagement with HYCCA
Research • EPAT study • Edinburgh Pain Assessment Tool • Looks at documenting pain as one of the vital signs in cancer patients • Protocols to follow depending on pain scores and type of pain • Pilot study shows improved pain management
Service developments in the last year • In-reach service to acute services at HRI • Daily visits to HRI • Collaboration with Dove House Hospice • Building links with community services • Building links with non-malignant disease services • Heart failure MDTs • Joint working with liver team
The Future Developing a seamless service across palliative care providers Developing a 7 day service Further developing links with non-malignant disease areas Improving End of Life Care in the acute hospital
Thank you Any questions?