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P-63 Increasing the use of, and exploring junior doctors understanding of, individualised care plans for dying patients at an east London district general hospital in 2021
  1. Rachael Bygate,
  2. Ava Zamani,
  3. Alex Belshaw and
  4. Valerie Potter
  1. Bart’s Heath NHS Trust


Background We observed at our Trust, a reduction in the number of dying patients being supported with our individualised care plan for the dying (Compassionate Care Plan; CCP) during 2021 and sought to both improve this and explore junior doctors’ understanding of the plan.

Methods An audit was designed to review the use of CCP documentation as well as other allied measures for one month pre interventions and for one month following. The interventions included paper copies of the CCP document being placed in accessible locations and posters explaining the role and rationale of the CCP placed in communal rest and work areas. Alongside this an online survey about the CCP was sent to junior doctors.

Results CCP usage was largely unchanged (87% compared to 84%) across the two months and palliative care referrals and anticipatory medications prescriptions had declined by 16% and 9% respectively. There had also been a decline in communication with next of kin. The initial interventions had not improved CCP usage but it highlighted the correlation between anticipatory medication prescribing, NOK communication and palliative care team reviews. The second part of our project was to investigate junior doctors understanding of the CCP. Our results showed that 100% knew what the CCP was, 90% had previously completed one and 81% felt comfortable suggesting it to a senior. However only 59% knew where to find it and only 72% felt it was a useful tool in end of life care.

Conclusion Although our interventions did not improve end of life care through CCP utilisation, it has informed us which strategies to focus on instead; namely accessibility of the document, the importance of referring to the hospital specialist palliative care service and the need to improve junior doctors understanding of the value of individualised care planning for dying patients.

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