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P-196 Inclusive palliation: creating a specialist palliative care service for vulnerable patient groups
  1. Rachael Pickering and
  2. Ruth Miles
  1. Greenwich and Bexley Community Hospice, London, UK


Background Author 1, a GP with expertise in caring for vulnerable patient groups (VPGs – e.g. homeless people, prisoners and substance misusers), works part-time in a city-based hospice alongside Author 2, the hospice’s lead palliative care consultant. It was noted that the hospice was receiving an increasing number of referrals for the palliative care of patients belonging to VPGs, and that their needs were increasingly complex. It is already known that high quality palliative care is achievable for patients belonging to VPGs, but that often novel techniques are required (Stienstra, Chochinov. Palliat Support Care.2012;10(1):37–42). It is also known that certain VPGs – e.g. prisoners – have particularly complex circumstances (Turner, Peacock. J Correct Health Care. 2017;23(1):56–65). It was decided to put Author 1 onto a new contract, majoring in specialist palliative care for these VPG patients.

Aims To evaluate the effectiveness of a new service for the specialist palliative care of patients belonging to VPGs.

Methods Spring 2022: literature review, evaluation of existing service, and service planning. Autumn 2022: launch of new service. Spring 2023: first cycle audit of service, and minor modification of service. Autumn 2023: second cycle audit of service, formal review of service, and recommendations for service development.

Results First cycle audit: there was a marked upturn in the number of VPGs referred internally to Author 1 for specialist management. Second cycle audit: the 2023 Hospice UK Conference coincides with the first anniversary of this service; the full audit cycle will be made available to the conference. Service development: evidence-based plans to develop the service will be presented.

Conclusions There is increasing demand for bespoke specialist palliative care for patients with VPG backgrounds. A city-based hospice piloted the deployment of a hospice GP with expertise in the care of VPGs. Data from the service’s first year will inform further service development.

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