20 May 2015
High quality end-of-life care at UH Bristol
The Supportive, Palliative and End-of-life care team at
University Hospitals Bristol is helping ward teams to deliver high
quality end-of-life care, in sharp contrast to national examples in
a report by the parliamentary and health services ombudsman.
The ombudsman's report found instances nationwide of poor
end-of-life care adding to the distress of patients and their
families, with problems including poor care planning, poor
communication, poor symptom control, and a lack of recognition that
people are dying and a failure to respond to their needs.
By contrast, UH Bristol's supportive, palliative and end-of-life
care team's service was rated good in the Trust's Care Quality
Commission's report last December, and identified as providing a
caring, responsive, well-led, safe and effective service.
The CQC's report said: "The specialist palliative care team was
innovative and adapted to local needs and national policy by
continually developing and evaluating tools and training to promote
good end-of-life care for patients. The team shared its knowledge
and learning within the trust and published its research. The
team's responsiveness, support and skill were highly regarded by
colleagues throughout the trust. The team was established in wider
palliative care networks, including the local hospice and clinical
commissioning group."
Sophia Bloor, joint lead nurse for supportive, palliative and
end-of-life care, said: "We know that early communication of
patients' prognoses provides a better opportunity for good
end-of-life care to be put in place. We've done a great deal of
work at this Trust on identifying patients at an earlier point in
their illness, so we can put support in place for them as soon as
possible. There are also a lot of processes in place to ensure that
a patient's prognosis is communicated to them properly, and that
they understand it.
"As an acute hospital trust, our approach to end-of-life care
comes from a slightly different angle. For us, the focus is on
ensuring patients have a good death, rather than where they die.
While it's vital that we do what we can to discharge patients to
their preferred place of death, it's about making sure that if
patients die while they're at UH Bristol, they have as good a death
as possible."
Jo White, joint lead nurse for supportive, palliative and
end-of-life care, said: "Working closely with the staff who look
after these patients day-to-day is an essential part of that, so to
that end we've recruited and trained 30 ward-based nurses to be
end-of-life care link nurses. Good communication, education and
training for staff around end-of-life care is essential, and it's
something we're continually working on. We believe that every
moment counts for patients, relatives and carers and therefore
delivering high quality end-of -life care Trustwide is
essential."
The team has also piloted focus groups for bereaved relatives,
enabling them to give feedback about the care their relative
received. The feedback gathered from these sessions allows the team
to refine elements of their service, or make changes and
improvements to practice across the Trust if required.
This week as part of Dying Matters Awareness week, which aims to
raising awareness of the issues we face around dying, death and
bereavement, the team has had information stands in the main
receptions of the BHOC, BRI and the BHI during the week, to be
available for discussion and to provide resources for patients,
carers and staff members.
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