Aim To survey activities undertaken by specialist palliative care teams within the acute hospital setting and community examining referral response times, complexity of caseload and impact/effectiveness of the SPCTs involvement with patients and carers.
Method Over a 2 month period practice across sixteen specialist palliative care teams within the Yorkshire sub regional area was surveyed. A data collection tool was modified from one originally developed In Bradford based on STAS and PaCA. Each team collected consecutive data for thirty patients who had had more than one face to face assessment or until the agreed audit time period had elapsed, whichever was the sooner. Data was collated and analysed using Microsoft Access and SNAP by a central team.
Results Data was collected for 584 patients (315 community teams, 200 hospital teams and 69 dual role teams). Overall 85% of patients had a cancer diagnosis although there were wide variations in numbers of non-malignant referrals by teams. SPCTs demonstrated good response times to referrals despite there being variation in response time standards between locality and setting. Patients presented with multiple needs (average 3 to 4 problems per patient) and 74% had at least one problem scored as moderate to severe. 76% of all moderate to severe physical problem scores and 81% of all moderate to severe psycho-social problem scores were reduced after SPCT intervention (both patient and family).
Conclusion We have demonstrated the possibility of undertaking a regional survey through collaborative working. The survey has demonstrated the complexity and severity of problems seen in patients presenting to SPCTs and in light of these findings, evidence of need to provide 7 day face to face access to SPC should be reviewed. Common standards for initial response time contact, face to face assessment and discharge should also be agreed across the sub regional teams.
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