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Supportive & Palliative Care Team

The Papworth Hospital supportive and palliative care team supports patients who have long term conditions, life threatening illness, or are experiencing distress related to their health.

The team focuses on improving quality of life. Physical symptoms e.g. pain, nausea, insomnia (difficulty sleeping) can be addressed together with other aspects of a patient’s life which are affected by the uncertainty of incurable disease. Working with not only physical symptoms but also spiritual, social, financial and psychological issues is described as ‘holistic’ care.

The team work in all areas of the hospital, offering support and advice. They may talk directly with patients and carers, or they may discuss aspects of care and management with the patient’s own medical team.

Patients and/or carers can be seen during an inpatient stay, an outpatient visit or on occasions by telephone assessment. After discharge, if further support is needed, the team would attempt to arrange appropriate care from the patient’s local specialist palliative care services.

The team recognise the importance of addressing all issues affecting a patient’s quality of life, and therefore discuss patients referred to them at a weekly multidisciplinary meeting. Considerable time is also spent in discussing patients with their hospital team, negotiating how best to support all involved. Outside the hospital the team link with other healthcare professionals who may support the care of Papworth Hospital patients, e.g.  GPs, heart failure nurses, respiratory nurse specialists.

Key terms and definitions

Supportive care is an ‘umbrella’ term for all services that may be required to support people with life threatening illness. It is not a response to a particular disease or its stage, but is based on the assumption that people have needs for supportive care from the time that the possibility of a life-threatening condition is raised.

Palliative care is the active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments.

End-of-life care is care that helps all those with advanced, progressive, incurable illness to live as well as possible. It enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last phase of life and into bereavement. It includes management of pain and other symptoms and provision of psychological, social, spiritual and practical support.

How referrals are made

Any healthcare professional can refer a patient to the supportive and palliative care team. Patients and families may also request support for themselves if needed.

The referring healthcare professional must ensure that the patient and the consultant whose care they are under agree to the referral.

Some commonly occurring issues which may prompt referral are:

  • Issues of loss (e.g. body image, role etc)
  • Pain
  • Nausea/vomiting
  • Bowel or bladder problems
  • Poor sleep
  • Breathlessness/cough
  • Anxiety/panic
  • Depression
  • Oral problems
  • Lethargy/fatigue
  • Receiving bad news
  • Planning for discharge in a complex palliative care situation
  • Spiritual or religious issues
  • Bereavement issues

When making a referral from outside the hospital the following information will be needed:

    Name of patient
    Hospital and hospital number (if available)
    NHS number
    DOB
    Gender
    Patient address and telephone number
    GP address and telephone number
    Next-of-kin
    Patient's occupation
    Patients' living arrangements (type of housing etc.)
    Name of patient's consultant
    Details of any other professional involved in the patient’s care
    Diagnosis
    Reason for referral
    Urgency of referral

The team

The team can be contacted Monday to Friday within office hours. A voicemail service operates outside office hours.

Secretary direct dial: 01480 364747
Safe Haven fax: 01480 364914

Out of hours advice

For out of hours palliative care advice please contact the on call consultant via the Papworth Hospital switchboard (01480 830541)

Breathlessness Clinic

The breathlessness clinic is a nurse led, non-pharmacological approach to managing breathlessness. This approach can be used when all reversible causes for breathlessness have been excluded.

The clinic involves four visits; the first three involve exploring pacing activities, anxiety management, and energy conservation. The fourth visit is a review of these visits and their effectiveness prior to discharge. Other professionals involved in the clinic are the occupational therapist and the physiotherapist.

For a referral to the breathlessness clinic please contact or write to Tracy Simpson (Tel. 01480 364520) or Julie Southon (Tel. 01480 364154), Specialist Nurse, Papworth Hospital.

Patient information leaflets

End of Life (EoL) care

The care of all dying patients must improve to the level of the best."

Sir Nigel Crisp (Chief Executive NHS 2000-2006)

 

How people die remains in the memory of those who live on."

Dame Cicely Saunders founder of the modern hospice movement

In July 2008 the Department of Health published the ‘End-of-Life Care Strategy’ promoting high quality care for all adults at the end of life. Within the strategy ‘end of life’ is considered to be the last 12 months or so, of a person’s life. The National Institute for Health and Clinical Excellence (NICE) has published a Quality Standard for End of Life Care to guide the provision of high quality End of Life care for any person in any setting.

The End of Life care strategy and the NICE Quality Standard recognise key factors in improving the care delivered in the last months of life, including the recognition of what stage a patient’s illness has reached, and communication both between healthcare professionals, and with patients and their families. Coordinating a patient’s care, supporting their family/carers and supporting a patient in discussing what their wishes are around how and where they are cared for are all recognised as important ways of ensuring a patient receives the care they would wish.

In order to ensure coordination of care between healthcare professionals a patient’s GP is required to include them on a register to ensure their needs are regularly discussed and addressed at multidisciplinary meetings.

Expressing wishes around future care is known as ‘Advance Care Planning’ – there are national documents (e.g. Preferred Priorities for Care, Planning for your Future care) available to support this.

Patients who have written information about their wishes are encouraged to carry copies of their documents to show to healthcare professionals.

The supportive and palliative care team at Papworth Hospital work to ensure all patients, at whatever stage of their illness have their supportive care needs identified and met. The team use national guidance and documents in their work, and will support patients and carers in their discussions and in the use of any documents as appropriate.

The Supportive and Palliaitve Care team medical consultant chairs the Papworth Hospital End of Life Care steering group, which works to oversee and implement quality End of Life care across the Hospital, in line with National Guidance. The team are always keen to receive comments and/ideas on how to improve their service, which can be sent or emailed.

 

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