Background Northumbria Healthcare NHS FT specialist palliative care hospital liaison service (HLT) is a unified team working across three acute hospital sites with one Specialist Emergency Care Hospital (NSECH). Patients are admitted to specialty wards in NSECH for urgent assessment and treatment. If their condition is stable but requires them to stay in hospital for longer than 48 hours they are transferred to one of the other two ‘base’ hospitals (WGH or NTGH) for ongoing medical, and palliative, care.
Methods Data were collected using a standardised database across the three sites. Age, diagnosis, Australian modified Karnofsky Performance Scale (AKPS), phase of illness, and duration of episode of care (time from referral to discharge/death or transfer) were analysed for three sites between August 2018 August 2019.
Results Data demonstrates that patients in NSECH were younger, more likely to have cancer (66%), and had a mean duration of episode of care of 1 day. In contrast, patients in the base hospitals were older, with 66% and 73% of patients, respectively, over 75: in NTGH 40% of patients were over 85 years old. These patients were more likely to have non-malignant disease (45% with non-malignant disease), and frailty was the primary diagnosis in 13%; frailty and dementia combined were the primary diagnoses in 18%. In spite of this, AKPS was similar across all three sites, with the majority of patients being 30% or less.
Discussion Acute services across the whole trust have been transformed since NSECH opened, and the HLT patient population across the three sites has radically changed. This is a responsive team which has adapted to patient need on the individual sites, and reconfigured in an iterative manner according to this need. Future palliative care services must be able to adapt and respond to the increasingly dynamic demands of the population.
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