Friday 1st July 2016
Mac Voice, the magazine for Macmillan professionals: Summer 2016
Sinead Benson, Macmillian Palliative Care Nurse, works in acute areas to identify patients with palliative care needs.
The Acute Palliative Care Nurse post was developed due to concerns within the Countess of Chester NHS Trust that there were delays in referring patients to the Hospital Specialist Palliative Care Team after admission. As highlighted in the Trust Mortality Review, there were patients who would have benefitted from support from palliative care who were not being referred.
Macmillan agreed to fund a one year-pilot of a band 6 palliative care nurse, based in Accident and Emergency, the Acute Medical Unit and the Ambulatory Care Unit, to increase the early identification of patients who would benefit from palliative care.
The overall purpose of my post is to improve the experience of people with specialist palliative care needs in the acute setting. This is acheived through early identification, resulting in improved and timely access to services. Having worked in palliative care for over ten years, both within a hospice setting and as a community palliative care nurse, I knew it would be a daunting experience working in an NHS Trust in very busy departments, but also an exciting challenge.
Results of the pilot
Each day, I proactively identify and assess patients who have palliative care needs. This includes people with malignant or non-malignant disease, who may require specialist advice around symptom management, or psychological support for themselves and family members or carers. I also work very closely with acute oncology nurses within the trust. From their patient referrals for acute departments, they highlight patients who require palliative care as well as input from their team.
As result of this there has been a reduction in the average time from admission to referral to the palliative care team. This has also reduced the time from referral to being seen to its lowest level since 2011.
Since the introduction of my post, there has been an increase in the number of people with specialist palliative care needs referred to the team (based on pro rata calculations for first five months). We have also seen a reduction in the average length of stay, for all patients seen by the palliative care team, by three days, from 20.88 to 17.09; significantly lower than the predicted trend of 22.34 days.
Feedback from health and social care professionals:
‘Having prompt palliative care support within the Acute Medical Unit has allowed us to manage patients’ symptoms in a timely manner, improving patient care and at times facilitating an earlier discharge. Having Sinead working with us has also prompted us to involve palliative care services earlier than we might have in the past’
Feedback from patients and carers:
‘My family have been very blessed with all your help. All of our family have had great support. Thank you’
‘The palliative care team have been excellent’
‘They do an amazing job’
The Countess of Chester NHS Trust has agreed to permanently fund the post given the success. I believe that there is an exciting future for this post including further development.