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Poster Numbers 242 – 279 – Palliative care: all conditions and all ages: Poster No: 250
COPD referrals to specialist palliative care services (SPCS) in Salford: are we improving practice?
  1. Elizabeth O'Brien1,
  2. Ann Norris1,
  3. Olwyn Perkin1,
  4. Kirsten Donnelly2 and
  5. Stephanie Gomm3
  1. 1St Ann's Hospice, Manchester, UK
  2. 2The Christie NHS Foundation Trust, Manchester, UK
  3. 3Salford Royal NHS Foundation Trust, Salford, UK

Abstract

Background COPD is a leading cause of morbidity and mortality worldwide with a high physical and psychological symptom burden. A joint Palliative Care and COPD Working Group was established in 2007 to address the needs of patients with end-stage COPD in Salford, England where there is a higher prevalence of COPD than the national average (2.4% vs 1.4%).The group reviewed referrals to SPCS over a 12-month period before and after commencing joint working to establish their source, reasons for referral, and outcome. Nine audit standards were derived for evaluation of future practice. Aim: To audit the referral, initial assessment and outcome of all referrals to SPCS in Salford between October 2010 and March 2011 for patients with a primary diagnosis of COPD and compare to data obtained in 2007/8.

Method A retrospective case note review of all referrals to Salford SPCS (hospital, hospice and community) using a standardised data collection tool. Results: 95 referrals received by SPCS in a 6-month period during 2010/11 were compared with 21 in a 12-month period in 2007/8. 57 referrals (39 patients) were analysed: Prognostic information was evident in 43 % vs 39% in 2007/8. 59% of patients were GSF registered at referral compared to 52% in 2007/8; with the majority discussed regularly at primary healthcare meetings. Overall, there was a higher symptom burden elicited and documented with advice given on additional treatment. Preferences for future care were discussed in 37% of assessments but only completed in 20%, compared to 28% in 2007/8.

Conclusion There was a significant increase in the number of referrals to SPCS between 2007/8 and 2010/11, with 1 in 4 patients accessing multiple services. Areas of practice improved in particular identification of symptom burden but further collaborative work is needed to promote advance care planning in this patient group.

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