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Acute hospital specialist palliative care: multidisciplinary team models and workforce in South West England
  1. Roger William Smith1,
  2. Suzanne Tween2,
  3. Charlotte Chamberlain3 and
  4. Jane Gibbins4
  1. 1 Department of Palliative and Supportive Care, Somerset NHS Foundation Trust, Somerset, UK
  2. 2 Department of Primary Care, Royal Cornwall Hospitals NHS Trust, Truro, UK
  3. 3 Department of Supportive and Palliative Care, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  4. 4 Department of Palliative Medicine, Cornwall Partnership NHS Foundation Trust, Cornwall, UK
  1. Correspondence to Dr Suzanne Tween, Primary Care, Royal Cornwall Hospitals NHS Trust, Truro, UK; suzanne.tween{at}


Objectives Acute hospital specialist palliative care teams (SPCTs) improve patient care and reduce length of stay. UK guidance recommends SPCTs provide face-to-face assessments 7 days a week and offer 24-hour telephone advice. Little published data exist on SPCT staffing models.

This paper aims to explore team structure, funding and impact of COVID-19 on SPCTs across the South West (SW) of England (population of nearly six million).

Methods Electronic survey to SPCT clinical leads in 15 SW acute hospitals.

Results All 15 acute hospitals have an SPCT. There was variability in SPC clinical nurse specialist and consultant availability, 0.27–2.7 whole-time equivalent (WTE) and 0.1–1.5 WTE, respectively, per 250 beds. 13/15 (87%) provide out-of-hours (OOH) palliative care advice with 60% reliant on charity services. Few SW teams meet national guidance for SPC staffing to bed ratios. 8/15 teams reported greater integration with other services during the COVID-19 pandemic.

Conclusion There is significant variability in SPCT structure and staffing. The charity sector (independent hospices) often provides OOH acute hospital SPC advice. Further research is needed to consider the impact of different SPCT models on patient and family outcomes, and the sustainability and opportunities offered by integration of services and collaboration across care settings during COVID-19.

  • Service evaluation
  • Hospital care

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  • Contributors JG presented the idea. RWS and ST designed the survey and organised and conducted data collection. RWS, ST, CC and JG contributed to data analysis and evaluation of results. RWS drafted the initial manuscript with assistance from ST and JG. Critical revision of the manuscript was performed by ST, RWS, CC and JG, with contributions from Saskie Dorman and Hasib Choudhury. The final version of the manuscript was written and approved by RWS, ST, CC and JG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests The authors have interest in sustainable funding models and well-functioning specialist palliative care teams, where their income is dependent on NHS and/or charitable funding.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.