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

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"As palliative care evolves, the management of patients is becoming increasingly complex, and drugs are often used with which an OOH doctor may not be familiar," says Dr Fergus. If special notes from GPs are not being used for these patients, visiting OOH doctors are likely to be faced with an unfamiliar situation with no information or suggestions to help them manage the patient. "As some of these doctors may not be familiar with local services, there is a danger that those patients with the most complex needs might be admitted, and that this admission might be to an inappropriate service, or against the express wishes of the patient and family."

The study also highlights the lack of detailed statistics available about palliative care patients using OOH services and suggests that health professionals could better capture these data in future.

The authors recommend a special dedicated form (enhanced special note) for GPs to send to NHS24 with full information about palliative care patients. The form should be easy to send electronically and have a regular review date to keep it current, especially for patients on complicated drug regimens. Electronic palliative care summaries are now being developed in Scotland and will be routinely sent, with patient consent, to OOH services to improve communication.

The authors also recommend expanding patient-held nursing notes so that all visiting professionals should routinely complete them. They further recommend that certain patients with complex needs should be allowed to bypass NHS24 to access specialist services (where they exist) OOH. Such a scheme, where palliative care patients are provided with a direct local contact number and the local service has details of their condition, has been in place for some time in the Borders Region of Scotland and the North East of England.


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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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