Specialist Palliative Care
Specialist palliative care (SPC) has expanded since it’s origins and not only supports patients where required at end of life but also supports symptom control in potentially life-limiting conditions. The emphasis of the speciality has always been on holistic care of the patients. Patients may be referred with any life-limiting condition, be that a form of cancer or non-cancer.
End of life care is defined as care provided in the expected last year of life. It is common that people will associate the term ‘End of Life Care’ with a much shorter time before someone’s death.
The SPC team will not see every patient who is approaching the end of their life and we recognise that end of life care is provided by all staff within healthcare. As such our trust are dedicated to improving EOLC across the board and the SPC team work closely with al clinical areas to assist with this. See below for more details around end of life care.
When might Specialist Palliative Care team referral be appropriate?
The SPC team see patients who have complex symptoms which have not responded to usual measures. Patients will usually have an advanced, progressive, potentially life-threatening condition and this can be any illness, not restricted to cancers as is sometimes thought to be the case.
We are also increasingly asked to review patients having very active management of their condition to review difficult symptoms and this is often referred to as ‘Enhanced Supportive Care’. You should not be alarmed if it is suggested that you are seen by the team as it can allow us to ensure we are optimising your quality of life and helping you to live well through your treatment.
Types of support we can provide:
- advice and support on the management of symptom control issues including pain, nausea and vomiting, fatigue and breathlessness
- psychological support and advice for you, your family and carers
- spiritual and cultural needs
- social and financial issues
- planning for discharge, liaising closely with health and social care teams in the local community
Referrals are accepted from all healthcare professionals although we will confirm referral with inpatient hospital Consultant or GP as appropriate.
Who is in our team?
Our trust has a specialist palliative care team consisting of doctors, advanced nurse practitioners, specialist nurses, occupational therapists, social work and psychologists. In addition, the team work incredibly closely with all teams in the trust and community as our community specialist palliative care team are employed by the trust and out-reach into the community.
How do we see patients?
Hospital specialist palliative care
- There is an inpatient hospital team with staff based on each site 9-5, Mon-Fri.
- Where possible, patients are seen within one working day but the urgency of need is assessed through the referral information.
Community specialist palliative care
Our community team can review patients in out-patient clinics or where needed in their own homes, they also operate between 9am and 5pm, Monday to Friday.
Referrals are triaged according to the information provided on the Community Specialist Palliative Care Nursing Service Referral Form
Outpatient clinics
- We offer out-patient reviews with the Medical Consultants in a variety of locations.
- In addition, we are developing Enhanced Supportive Care clinics which support patients at an earlier stage following a cancer diagnosis. These clinics are undertaken by a range of specialist from the palliative care team and oncology services.
Out-of-hours
- For out-of-hours concerns, all healthcare professionals across the county can contact our team for telephone advice.
- We do not currently have a visiting service due to ensure that we can provide some cover for the whole county.
Guidelines for health professionals
- Palliative care guidance NHS Scotland
- End-of-life discharge planning
- End-of-life discharge essential resource guide during COVID-19
- Guidance for symptom control in end of life care
- How to prescribe controlled drugs
- Management of blood sugars when on steroids
- Management of diabetes in last days of life
- Opioid conversion calculator
- Supportive care for renal patients
- Transdermal patch where eGFR greater than 30 mmolsl
- Transdermal patch where eGFR less than 30 mmolsl
- Responsibilities of staff
- Public facing responsibilities of staff EOLC
- What does EOLC training look like at GHNHSFT?
- End of life care core skills education and training framework
- Guidance for management of breathlessness
- Emergency COVID-19 end of life care medication guidelines
- Emergency non COVID-19 end of life care medication guidelines