Search the hub
Showing results for tags 'Medicine - Palliative'.
Found 48 results
-
Content ArticleProviding high quality care and treatment for patients coming to the end of their lives is likely to involve making difficult and emotionally challenging decisions. This guidance from the General Medical Council provides a framework to support doctors in meeting the needs of each patient as they come towards the end of their life.
-
Content ArticleThis short animated video explores the issue of prioritising equality in shared decision making, to ensure that all patients' and family members' values are sought and incorporated in treatment decisions.
-
News Article
Dying patients living longer than expected lose NHS funds
Patient Safety Learning posted a news article in News
More than 1,300 patients a year are having NHS funding for their palliative care withdrawn after living longer than expected, BBC analysis shows. Terminally ill or rapidly-declining patients are given fast-track support, allowing them to live outside hospital. From 2018 to 2021, a total of 9,037 people had this funding reviewed in England and Wales, with 47% of them losing all support. A further 15% of patients had their continuing healthcare support replaced with the more limited NHS-funded nursing care. Sandra Hanson was referred to the fast-track pathway of the NHS continuing healthcare scheme in mid-2020, after her needs were judged by a clinician to be "end of life". She was diagnosed with end-stage dementia, and had been in hospital eight times in the previous year following multiple falls and bouts of pneumonia. The funding covered the costs of a nursing home, where she suffered fewer falls. But in March 2021, this funding was reviewed by her local Clinical Commissioning Group (CCG). These assessments, usually undertaken by a multi-disciplinary team including health and social care professionals, consider the severity of a person's needs in areas such as mobility, cognition and behaviour. Sandra's daughter, Charlotte Gurney, said the family was represented by a social worker they had not previously met, and describes the meeting as "traumatic" as she tried to explain her mum's needs. "We just felt not listened to... we were treated as if we were trying to swindle the system. Sandra's support was withdrawn, and she had to be moved to a new nursing home, financed by her husband Malcolm. Shortly afterwards, she broke her wrist following a fall and injured her face. The family believe had the review correctly identified Sandra's needs and risks, this could have been avoided. Read full story Source: BBC News, 17 March 2022 -
News Article
End-of-life care will become a legal right
Patient Safety Learning posted a news article in News
Dying people will be given an explicit legal right to healthcare for the first time in NHS history, requiring every part of England to provide specialist palliative care. New analysis from the charity Marie Curie shows that about 215,000 people a year miss out on end-of-life care and that without intervention this could rise to 300,000 within 20 years. The government will back an amendment to the Health and Care Bill in the House of Lords. Baroness Finlay of Llandaff, a professor of palliative care medicine and supporter of the amendment, said: “This change is incredibly important. For the first time the NHS will be required to make sure that there are services to meet the palliative care needs of everyone for whom they have responsibility in an area. People need help early, when they need it, seven days a week — disease does not respect the clock or the calendar.” She told the Lords that although “general basic palliative care should be a skill of every clinician”, specialist palliative care was a “relatively new specialty, which is why it was not included in the early NHS legislation”. The government amendment will introduce a specific requirement for “services or facilities for palliative care” to be commissioned by integrated care boards, responsible for local services under the government’s NHS reforms, in every part of England. Matthew Reed, chief executive of Marie Curie, said: “If you need palliative and end-of-life care today, the chances of you getting the pain relief, symptom control and support for your family that you need depend largely on where you live, your ethnicity, gender and on what condition you have. This is wrong. “We welcome the news coming out of the Department of Health and Social Care. The impact of this legal requirement to provide appropriate care to dying people could be transformative — it is one of the biggest developments in end-of-life care since the inception of the NHS. This change has the potential to end the current postcode lottery and make end-of-life care fair for all." Read full story (paywalled) Source: The Times, 25 February 2022 -
Content ArticleCOVID-19 has meant people have died the ultimate medicalised deaths, often alone in hospitals with little communication with their families. But in other settings, including in some lower income countries, many people remain undertreated, dying of preventable conditions and without access to basic pain relief. The unbalanced and contradictory picture of death and dying is the basis for the Lancet Commission on the Value of Death. Drawing on multidisciplinary perspectives from around the globe, the Commissioners argue that death and life are bound together: without death there would be no life. The Commission proposes a new vision for death and dying, with greater community involvement alongside health and social care services, and increased bereavement support.
-
News ArticleDeath has become “over medicalised” and the public should be encouraged to discuss dying and grief, experts have said. There's a call for shift in attitude towards palliative care, with more emphasis on compassion and less on giving medication that may prolong pain. According to a new Lancet commission, an overemphasis on aggressive treatments to prolong life, global inequities in palliative care access, and high end-of-life medical costs have led to millions of people suffering unnecessarily at the end of their life. The authors also note that the pandemic has made death and dying more prominent in daily life, while health systems have been “overwhelmed” when trying to care for those dying. People often died alone, with families unable to say goodbye to loved ones or grieve together, the commission said – the effects of which will “resonate for years to come”. The researchers argue that many people, mainly in low- and middle-income countries, have no access to end-of-life care, and particularly to opioids, while those in high-income countries may be overtreated. Attitudes towards death and dying should be “rebalanced”, the authors conclude, away from a medicalised approach towards a “compassionate community model”, where families work with health and social care services to care for those dying. Read full story (paywalled) Source: The Telegraph, 31 January 2022
-
Content Article
This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.- Posted
- 5 comments
-
1
-
- (and 14 more)
-
Content ArticleIn this article in the Pharmaceutical Journal, Carolyn Wickware asks if liquid morphine should be reclassified. She cites research that Oramorph or oral morphine sulphate solution was directly linked to the cause of death in 13 reports since 2013.
-
Content ArticleDr Claud Regnard (Honory Consultant in Palliative Care Medicine, St Oswald’s Hospice) explains the Mental Capacity Act (England and Wales) and the legal requirements for making best Interest decisions when someone lacks capacity to make a particular decision. This webinar was produced by the Palliative Care for People with Learning Disabilities (PCPLD) Network.
-
Event
Palliative care and patient safety
Sam posted an event in Community Calendar
Dr Donna Prosser, Chief Clinical Officer, Patient Safety Movement Foundation, is joined by a neonatal palliative care expert, an adult palliative care expert, and a family member representative for palliative care to discuss introducing palliative care conversations, embracing shared decision-making, differentiating palliative care from end of life care, and implementing organisational initiatives to improve consistent and meaningful palliative care delivery. Register -
Content Article
Patient Safety Movement APSS: Palliative care
Patient Safety Learning posted an article in End of life care
Early palliative care intervention reduces hospitalisations and ensures optimization of patient comfort and trajectory of treatment. However, patient safety and palliative care initiatives are not as integrated as they should be, considering many palliative care patients have a limited prognosis, have complex, multifaceted conditions, and are, therefore, more susceptible to detriment due to error. Furthermore, there is a lack of a clear distinction between end of life care, palliative care, and hospice care, which confounds the subsequent processes. Because these issues overlap significantly, interventions can be optimised for efficiency. This document provides a blueprint that outlines the actionable steps organisations should take to successfully improve palliative care access and coordination and summarises the available evidence-based practice protocols. -
Content ArticleThis article from Petriceks and Schwartz, published in Palliative & Supportive Care, describes a four-element approach centered on Goals, Options, Opinions and Documentation that serves as an effective structure for clinicians to have conversations with patients and families to address care management when the path forward is unclear.
-
Content ArticleIn a new series for the hub, Martin will be interviewing healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Learning from frontline staff is crucial, now more than ever. Prior to a predicted second wave hitting us, the government and leaders must listen to what has gone well but, most importantly, not so well for both staff and patients. Martin is a passionate nurse working on a covid unit and wants to promote learning to ensure patient and staff safety. This initially started as a way of connecting and not feeling alone but what Martin has found is that there are many voices that need and want to be heard but just don’t know how to speak up and out. In all of the interviews the healthcare professionals wanted to remain anonymous which is indicative of their fear of reprisals from their organisation. In this first interview, Martin interviews a new student district nurse who has been working within the community in the South West. Their role involves supporting care homes with end of life care and assisting in keeping people with long term conditions at home.
- Posted
- 2 comments
-
- (and 5 more)
-
Content ArticleThe current COVID-19 pandemic has necessitated the redeployment of NHS staff to acute-facing specialties, meaning that care of dying people is being provided by those who may not have much experience in this area. This report published by Future Healthcare Journal, details how a plan, do, study, act (PDSA) approach was taken to implementing improved, standardised multidisciplinary documentation of individualised care and review for people who are in the last hours or days of life, both before and during the COVID-19 pandemic. The documentation and training produced is subject to ongoing review via the specialist palliative care team's continuously updated hospital deaths dashboard, which evaluates the care of patients who have died in the trust. It is hoped that sharing the experiences and outcomes of this process will help other trusts to develop their own pathways and improve the care of dying people through this difficult time and beyond.
-
Content ArticleAll hospitals have access to specialist palliative care teams, whether as in-house hospital palliative care teams or in-reach teams from local palliative care services. These teams will be able to provide advice and support, but it will not be possible for them to provide direct care to everybody who needs it, especially as the pandemic progresses. This NHS guidance is aimed at all professionals looking after patients with coronavirus, and their families, in the hospital setting.
-
Content Article
Helping break unwelcome news (Health Education England)
Claire Cox posted an article in Coronavirus (COVID-19)
Health Education England has published a set of materials and films which aim to support staff through difficult conversations arising from the COVID-19 outbreak. -
Content ArticleToday we find ourselves in the middle of a pandemic. COVID-19 has swept across the globe with thousands dead, more seriously unwell, and a sense of anxiety and uncertainty within healthcare professions that is unlike anything we have seen. As the course of the viral illness becomes clearer, management guidelines are being produced, including around the topics of supportive and palliative care. To understand the real life implications of working on the front line, Dr Tavabie and Dr Ball, in this BMJ Supportive and Palliative Care article, conducted a series of short structured interviews with clinicians across the UK in a variety of healthcare settings, discussing their experiences and looking for themes arising from the current COVID-19 outbreak. They hope that quotes from these conversations make for an accurate description of our current time, and may be of interest now and in future. Read part two of the article
-
Content ArticlePalliative care services are under-resourced at the best of times. The 2017 Lancet Commission on Palliative Care and Pain Relief described the widespread lack of access to inexpensive and effective interventions as a travesty of justice. As health systems become strained under COVID-19, providing safe and effective palliative care, including end-of-life care, becomes especially vital and especially difficult, as discussed in this Lancet editorial.
-
Content ArticleThis is a guide to end of life care symptom control when a person is dying from COVID19 for General Practice Teams, prepared by the Royal College of General Practitioners (RCGP) and the Association for Palliative Medicine.
-
Content Article
This poster has been developed by Dr Antonia Field-Smith and Dr Louise Robinson from the Palliative Care Team at West Middlesex Hospital. It provides a guide for communicating with relatives with compassion during the Covid-19 pandemic.- Posted
- 2 comments
-
- (and 4 more)
-
Content ArticleThis link provides a framework for end of life care and breaking bad news during the Covid-19 pandemic. It has been created by e-LfH, a Health Education England Programme in partnership with the NHS and Professional Bodies. Resources include: Discussion of Unwelcome News during Covid-19 Pandemic: a framework for health and social care professionals Covid-19: Evidence-based advice for difficult conversations Scottish Quality and Safety Partnership Poster - unwelcome news Real Talk Framework Telephone Prompt List Real Talk Framework Sketch Note Video 1 - The framework Video 2 - Community (Advance Care Planning: how I have the conversation) Video 3 - Breaking bad news Video 4 - Ceilings of Treatment. Nb: The below link will take you to a landing page. To access the end of life resources listed above, you will need to go to the 'End of Life Care' folder and then to 'Documents and Videos'.
-
Content ArticleThis guidance is aimed at all professionals carers supporting patients with COVID-19, and their families, in the hospital setting – whether this is in critical care or elsewhere in the hospital. All hospitals have access to specialist palliative care teams, whether as in-house hospital palliative care teams or as in-reach teams from the local palliative care services. These teams will be able to provide additional advice and guidance but it will not be possible for them to provide direct care to everybody who needs it, especially as the pandemic progresses. This guidance includes flow charts to help aid treatment and symptom control. Nb: The most current version of the guidance document will be available on the public-facing pages of the Association for Palliative Medicine website (https://apmonline.org/). It is advised that you always check that you are referring to the most current version.
-
Content ArticleThe Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a process supported by the Resuscitation Council (UK) and UK Royal Colleges to create personalised anticipatory care plans for patients. Hampshire Hospitals NHS Foundation Trust has been an early adopter of this process with variability in engagement with this process across our trust. Published in Progress in Palliative Care, this paper describes a quality improvement project was performed to improvement engagement with ReSPECT as well as consistency and quality of documentation.
