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P-87 St Oswald’s Hospice Ambulatory Care Service Pilot Project
  1. Owen Lever,
  2. Jennifer Saunderson,
  3. Jolene Brown and
  4. Kath Clark
  1. St Oswald’s Hospice, Newcastle-upon-Tyne, UK


Background For patients with chronic, life-limiting haematological conditions such as Myelodysplastic syndrome (MDS), regular transfusion for relief of symptoms of anaemia requires frequent attendance to acute hospital. Literature demonstrates MDS is associated with significant impairment and poor prognosis with critical palliative care needs (Nickolich, El-Jawahri, LeBlanc, 2016). Opportunities to address these needs can be challenging in an acute environment. The COVID-19 pandemic led to a revision of services offered in St. Oswald’s Hospice day services with the development of a new ambulatory care service for patients requiring regular transfusion. This involves working with specialties to offer services to patients who would benefit from earlier palliative care support.

Aim Evaluating a pilot service to capture patient experience, patient need to access services available from palliative care MDT and working collaboratively with haematology services.

Method The pilot involved 11 patients referred by haematology services requiring regular blood transfusion. Records were kept of MDT services accessed alongside collated patient feedback.

Results Eleven patients referred between 31 March 2021 and 27 May 2021, with 26 individual attendances:

  • All 11 patients had initial assessment with a senior palliative medicine doctor.

  • Three patients have engaged in advance care planning discussions.

  • Three patients reviewed by physiotherapy.

  • Six patients received complementary therapy.

  • One patient reviewed by social worker.

  • Four patients had medical review for specific symptom management need.

  • One patient assessed by lymphoedema specialist.

  • Two patients referred to music therapist.

  • One patient admitted to the inpatient unit for observation overnight.

  • Feedback has been very positive from patients and their families.

Conclusion The initial pilot has been very positive with patients accessing palliative care services and engaging in advance care planning earlier. Increasing the number of referrals to the service will continue to widen access to patients not typically referred until later in their disease process, promoting improved quality of life and advance care planning.

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