P 12.018 Specialist Palliative Care at the Front Door

Published Date: 07th June 2023

Publication Authors: Howarth S, Thompson A, Beck D

Background and aims
At a time of significant pressure within the NHS, patients with palliative care needs often present to the emergency department in crisis. This makes the ED an important site for specialist palliative care assessment. It is widely recognised that 40 million people a year globally will require palliative care and this need is only expanding. Despite this fast-paced environment caring for those patients nearing the end of their life or have unmet symptom needs can be complex and at times difficult to manage.

Method(s)
From March 2022 a designated clinical nurse specialist (CNS) from the specialist palliative care team funded by the local CCG worked alongside ED physicians and managers to provide a 5-day a week service, working proactively within ED. The CNS would complete holistic specialist palliative care assessments whilst also providing education throughout the department. Data collected included number of referrals, patient demographics, reason for admission, palliative care diagnosis, time of referral to palliative care, time of palliative care assessment, outcome and length of time spent in ED. Data collected was compared to data from previous year which only included number of referrals.

Result(s)
Prior to this new service specialist palliative care were assessing 11 patients per month in ED. Since this service was implemented 50 patients are being. With this service we have assessed 330 patients in ED. From the data that has been collated there was an even split in gender, 90% of these patients had a pre-existing palliative diagnosis. 100% of all patients referred were assessed on the same day. 31% of patients are assessed in Resus and 54% are assessed in Stretcher Triage signifying those patients are seen on or soon after arrival to ED.

Conclusion(s)
Targeted palliative care input within ED can support patients with symptom control and aim to achieve their preferred place of care. This service is currently a pilot scheme and the aim is to present a business case to the trust.

 

Howarth, S; Thompson, A; Beck, D. (2023). P 12.018 Specialist Palliative Care at the Front Door. Palliative Medicine. 37(Suppl 1), p.207. [Online]. Available at: https://journals.sagepub.com/doi/10.1177/02692163231172891 [Accessed 30 October 2023]

 

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