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171 1 specialty 3 settings: the influence of combined oncology and palliative care clinics (COPC) on contacts with palliative care in hospital, community and hospice in Cornwall
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  1. Naomi Blower,
  2. Rhys Elgumati,
  3. Rachel Newman,
  4. Natasha Powell,
  5. Kirsty Scott and
  6. Ziad Zeidan
  1. University of Exeter Medical School, Cornwall Hospice Care, Royal Cornwall Hospitals NHS Trust

Abstract

Background Evidence suggests palliative care involvement alongside oncology care improves quality of life, planning and communication for advanced cancer patients. However, little information exists about the impact of such involvement on access to the speciality across care settings. This study examines the influence of COPC versus Standard Oncology Clinics (SOC) on palliative care contacts in hospital, community and hospice settings.

Methods Fifty-nine COPC patients were compared with fifty-nine SOC clinic patients, all with lung malignancies. 56/59 COPC patients and 59/59 SOC patients were first seen within 2017–2018. Data about involvement of community and hospice palliative care services was collected for 12 months from first contact with palliative medicine oncology consultant respectively. Hospital palliative care involvement was measured from 1 month before to 12 months after first consultant contact (thereby including those first diagnosed during a hospital admission).

Results Hospital palliative care services provided 28 care episodes in 20/59 (34%) COPC patients, compared to 19 in 14/59 (24%) SOC patients. Patients were already known to community palliative care teams in 15/59 patients attending COPC increasing to 46/59 within next 12 months. In SO the figures were 8/59 increasing to 24/59. Although higher numbers in the COPC group, the rate of increase is similar (approximately 300% increase over 12 months in each group) 7/59 (11%) of COPC compared with 3/59 (5%) of SO patients were admitted to a local hospice in 12 months from first contact.

Conclusions Review in COPC compared to SOC appears to increase access to hospital, community and hospice specialist palliative care services. This study involves a relatively small number of patients with lung malignancies, and larger studies, including patients with other types of malignancy, should expand the information available. Further data is also needed to evidence whether access to these services improves outcomes for patients and families.

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