Background The SARS-Cov-2 pandemic resulted in a rapid and unprecedented shift in the number of patients admitted to hospitals. In this trust palliative care provide a 9–5, 7 day/week liaison service. We evaluated the role of the palliative care services during the peak of the pandemic.
Methods We conducted a retrospective analysis of the demand on palliative care team (PCT) at the two acute hospital sites; Royal Free Hospital (RFH) and Barnet Hospital (BH). Trust referral data was recorded for a 6-week period between 18/03 and 29/04, 2020. Patient outcomes were documented on a standardised Excel-database. Clinical notes were audited at random to ensure quality of data capture.
Results During the period studied there were 597 deaths between both sites, 393 (66%) of which were documented as Covid-19 related. BH referred 178 patients to the PCT, of which 90% were Covid-19 related. RFH referred 99 patients, of which 58% were Covid-19 related. Clinical support provided to the wards caring for the patients was predominately in person at BH (97%) and via telephone at RFH (76%), with an average time to death after referral of 1.9 days at BH and 2.8 days at RFH. Approximately 16% of patients at both sites were discharged to other services for on-going care or end-of-life-care at home. The majority of pharmacological interventions were as-required medication (>85%) with fewer patients than anticipated needing a syringe driver (<60%). Clinical notes confirmed that most patients became symptomatic quickly, died rapidly after referral and communication with families via telephone was well documented.
Conclusions The two PCTs had different clinical experiences, this can be explained by the populations that each site serves, the structures within the teams and their physical location in relation to the wards. Excellent patient outcomes remained the same suggesting that both PCTs adapted well, with further shared learning planned.
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