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158 Has embedding specialist palliative care in an interstitial lung disease clinic impacted on referrals to a local hospice?
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  1. Kym Wakefield,
  2. Craig Gouldthorpe,
  3. Anne-Marie Bourke and
  4. Julie Harper
  1. Marie Curie

Abstract

Introduction The British Lung Foundation states there should be a clear, standardised pathway to palliative care for patients with Interstitial Lung Disease (ILD). Our regional ILD clinic is based at the Royal Victoria Infirmary in Newcastle upon Tyne. In January 2016, specialist palliative care from the Marie Curie hospice Newcastle was embedded in this clinic. Patients can access same-day palliative care and respiratory reviews. The hospice has a 20-bedded inpatient unit (IPU) and a day therapy unit (DTU).

Aims To evaluate the effect of a collaborative ILD palliative care service on the number of referrals to the Marie Curie hospice, Newcastle.

Methods All patients referred to the hospice between November 2017 and May 2019 with a primary coded diagnosis of a ‘non-malignant respiratory condition’ were identified using SystmOne. Specific diagnosis, referrer and reason(s) for referral were also collected.

Results A total of 38 patients were identified. The majority of these had a diagnosis of ILD (n=26); the remainder had chronic obstructive pulmonary disease (n=11) or bronchiectasis (n=1). The 26 individuals with ILD accounted for 37 accepted referrals to the hospice (DTU=21, IPU=16); some patients were referred more than once. 90% (19/21) of these DTU referrals originated from the ILD clinic. A wider source of referrals was seen for IPU. The most frequently occurring reasons for referral were breathlessness and cough.

Discussion We are unable to compare current referrals with those prior to 2016 because a different record system was used. However, a search found only one patient with ILD admitted to IPU in 2015. We conclude that this increase is an outcome of our collaborative service. Anecdotal feedback suggests that patients who have met a member of the hospice team in clinic find it easier to accept hospice referral - further research is needed to explore this.

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