Background Emerging evidence suggests early palliative care (PC) is beneficial in the care of patients with cancer (Berman, Mola, Elliott, et al., 2018; Mola, Campbell, Berman, et al., 2018; Temel, Greer J, et al., 2010). Clinicians’ views also require consideration as they aim to support and optimise care for these patients (Popescu, Schafer, Califano, et al., 2014).
Aims To evaluate our model of earlier PC on the Oncology Assessment Unit (OAU), assessing the effect on patients and clinicians.
Methods Two PC doctors attended the OAU at a tertiary cancer centre, for 45 sessions. PC intervention consisted of face-to-face review or advice. The number of, and reasons for referrals were recorded. Patient and staff questionnaires provided feedback. Staff responses were independently analysed to identify themes.
41 referrals: 32 face-to-face reviews; 9 advice only.
16/41 not previously known to PC services.
Seven patient and 10 staff questionnaires returned.
ResultsAll patients gave positive feedback and would recommend PC to family/friends. Thematic analysis of staff responses identified three themes:
Access to/engagement with PC services: Removing barriers to PC services, providing good links to Community PC Services. ‘Discussion with the PC doctor seemed to de-mystify/take away some of the fear associated with PC referral’
Quality of care: Good patient care, efficiency/patient flow, expertise in symptom control. ‘It has improved patient care on the two occasions I referred’
Preferred place of care, advance care planning, education/teaching. ‘This was highly beneficial to the patients as they wanted to be at home and we were able to carry out their wish safely’.
Conclusion Access to palliative care has been widened, quality of care and patient outcomes improved. Patients and staff were positive about early palliative care in this setting. Consideration is required to ascertain if this model of care is (a) the optimal use of resources and (b) transferrable to other settings.
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