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What do Doctors want from Out of Hours Specialist Palliative Care?

by Dr Paul Perkins

Poster Download

Background

There is debate about the optimum structure for services supporting patients with palliative care needs out of hours (OOH). In the UK, there is wide variation in the specialist palliative care (SPC) services offered. In Gloucestershire, healthcare professionals currently have access to a telephone advice line, but no face-toface assessments.

Aims

The primary objectives were:

  1. evaluate OOH SPC services currently available to hospital patients in Gloucestershire;
  2. determine the level of support hospital doctors think they require to manage palliative patients OOH.

Methods

An anonymous questionnaire was sent to doctors of all grades in Gloucestershire Hospitals NHS Foundation Trust to establish their understanding of the services currently available and the level of SPC support required OOH. We followed up with email reminders.

Results: 104 doctors replied. Only 30 had a correct understanding of the OOH SPC services available; 15 incorrectly thought that there was support from visiting SPC healthcare professionals. 49 had contacted the SPC team OOH at some point in their career, with the most common reasons relating to symptom control (33%) and medication advice (31%). 98% of participants found the advice they had received helpful. 76 participants agreed that an OOH telephone advice line was required, but of these, nearly half (46%) felt that additional support from visiting healthcare professionals was needed. 12.5% of participants felt that visiting SPC professionals were required instead of an advice line. 62% of participants believed that, with better education, clinicians would be less likely to require OOH SPC support.

Conclusions

Doctors valued the advice received from the OOH SPC team, but there was a lack of understanding about the precise services available. Despite this satisfaction, some felt that a visiting service would be of benefit. The majority thought that better SPC education would lead to less reliance on OOH SPC services."

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