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Better care at any hour for palliative patients
Date:2/19/2010

ty and specialist palliative care services to assess the current challenges and develop recommendations.

The community of Levenmouth is relatively deprived, and has both a high elderly population and an increased level of long-term life-limiting illness. Patients here might be expected to use OOH services more than average. Interviews with patients, GPs, palliative care professionals, district nurses and nurses offering OOH advice via NHS24 brought a number of core themes to light. The first was a need for better communication. GPs have been encouraged to complete special notes to inform the OOH service about patients who may contact NHS24 since its introduction in Scotland. However these notes were not specific enough for palliative care patients, were often sent too late and were generally under-used. District nurses were frustrated that they had to contact NHS24 to organize patient visits but could not directly discuss the patient with the OOH GP, and the outcome of a GP visit would not be available to a second nurse needing to make another visit OOH.

Some patients and their carers were reluctant to contact NHS24, describing the process as a 'rigmarole'. Many had found using the helpline stressful and cumbersome. They were also reluctant to use OOH services, through misunderstanding of its functions or because they were unwilling to speak to a stranger. Some believed mistakenly that NHS24 could access their full health records. Many patients practiced 'self-triage,' either waiting to see their own doctor and risking harm, or calling 999 (the UK emergency number) or visiting Accident & Emergency departments with their health problems.

Some clinicians also saw a need for certain palliative patients to bypass NHS24, and allowed them to contact nurses or other medical services directly. The authors suggest that these difficulties may occur in other areas of the UK, too, although a number of local developments are addressing some of these is
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Contact: Jayne Fairley
jayne.fairley@sagepub.co.uk
44-207-324-8719
SAGE Publications UK
Source:Eurekalert

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