Background Predicting patient prognosis is a challenging clinical decision and some studies report that clinicians often overestimate patient survival1. One important aspect of predicting prognosis is ensuring that patients are allocated the appropriate resources as part of their management, including continuing healthcare placement if appropriate. A continuing healthcare placement is funded via NHS resources and has set criteria including that all patients referred should have an expected prognosis of less than 3 months. Patients with a longer expected survival do not usually receive full NHS funding if transferred to a care placement.
Aims Audit of patients transferred from an NHS inpatient specialist palliative care unit (PCU) to a continuing healthcare funded placement to assess whether (1) prognosis was accurately predicted using multidisciplinary team expertise on the PCU and therefore (2) NHS funding was correctly allocated to these patients.
Conclusion 86% patients transferred from the NHS inpatient specialist palliative care unit (PCU) to a continuing healthcare placement lived for less than 3 months. Some of these had a survival significantly shorter than the predicted 3 months but it was difficult to determine from the medical notes if, on retrospect, this would have been expected. This in turn raises the issue of whether it may have been in the best interest of some of these patients to have remained on the PCU.
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