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P8 Care across settings: Evaluating an integrated specialist nurse-led palliative care clinic within a general practice setting
  1. Emily Harrop1,
  2. Jessica Baillie1,
  3. Anthony Byrne1,2,
  4. Karen Stephens3 and
  5. Annmarie Nelson1
  1. 1Marie Curie Palliative Care Research Centre, Cardiff University, Cardiff, Wales
  2. 2Cardiff and Vale University Health Board, Cardiff, Wales
  3. 3Marie Curie Hospice Cardiff and the Vale, Penarth Wales

Abstract

Background A community nurse-led palliative care clinic was introduced at a UK General Practitioner’s (GP) practice in April 2012. The clinic aimed to provide earlier identification of patients with cancer and non-malignant disease, initial patient assessment, education for GPs and other community professionals, and strengthen relationships with the local multi-disciplinary team. This provides a new model for engaging patients and ensuring that specialist palliative care is delivered across different clinical settings. Usually, clinical nurse specialists (CNS) support patients in the home. This new initiative brings a fortnightly clinic as a complementary resource to consolidate the joint primary/ palliative care approach.

Methods This study evaluates implementation processes and the impact of the clinic on patient experiences and professional practices. It assesses uptake of palliative services and the management and delivery of palliative care by GPs and CNS.

Baseline interviews with GPs (n = 5) and CNS (n = 4) were carried out in February 2012. Semi-structured interviews with patients (n = 6), GPs (n = 6) and CNS (n = 4) are being undertaken to assess perceptions of the clinic.

Patient interviews will be analysed using an Interpretive Phenomenological Analysis (IPA) approach. Interviews with GPs and CNS will be analysed using Framework Analysis.

Results Perceived aspirations for the clinic included: earlier referral; improved communication and continuity of care; psychological and practical benefits for patients/ carers; more targeted use of specialist nursing resources. Baseline interview data highlights the need for improved referral and communication practices, especially for non-cancer patients. Data from patient and follow-up interviews will be reported against these aspirations, with additional themes identified.

Conclusions and application Conclusions will be drawn on the effectiveness of the clinic and implications identified for palliative care provision in primary care settings, including the potential to roll out a similar model more widely.

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