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140 Improving collaboration between respiratory and palliative medicine, to address the unmet needs of patients with chronic obstructive pulmonary disease (COPD) in the last year of life
  1. Debra S Morris,
  2. Stephanie Stolberg,
  3. Christine Seddon and
  4. Rachael Burton
  1. Salford Royal NHS Foundation Trust


Background COPD guidelines recommend early access to palliative care together with optimal therapy for people with advanced disease. An acute respiratory ward and an innovative One Stop Palliative Care COPD clinic was used to test the theory that early palliative care intervention supports self-management, advance care planning and reduces avoidable hospital admissions.

Methods The introduction of a weekly Gold Standard Framework (GSF) meeting and the use of GSF prognostic indicators were initiated on a respiratory ward, to identify COPD patients in the last year of life. Patients were offered palliative care support, in hospital and community, to help them live well with the disease. A One Stop Palliative Care COPD clinic was introduced to promote self-management and advance care planning.


  • Hospital referrals have increased from 20% (Aug18–Jan 19) to 62% (Feb 19–July 19)

  • Community palliative care support has increased from 21% to 70%

  • Increase in documented advance care plans has increased from 46% to 90%

  • 77% of patients were identified and referred for inclusion on the GSF register

  • Patients were empowered to live well with the disease

  • Outcome measures have shown that COPD patients have a greater symptom burden than other patients referred to palliative care.

  • The project can be replicated across all disease groups

Conclusion This model has validated the theory that early referral to palliative care services for COPD patients in the last year of life, enhances patient care. It encourages and promotes living well with the disease, advance care planning with the intention of reducing avoidable hospital admissions.

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