Background The need to improve access to specialist palliative care services for people with end stage non-malignant lung disease is well evidenced. The unpredictable disease trajectory however challenges the traditional model of end of life care. The desire to improve access to services for this population locally inspired an exploratory pilot study integrating both specialist palliative care and respiratory medicine.

An existing respiratory out-patient review clinic has been adapted to focus on advance care planning, symptom management and assessment of needs on a monthly basis. Patients with advanced lung disease are invited to the clinic in particular those returning following an episode of non-invasive ventilation for type 2 respiratory failure. The clinic is provided jointly by a Consultant in Respiratory Medicine and a Clinical Nurse Specialist in palliative care.

Aims To introduce the concept of and facilitate discussions around advance care planning for patients and carers.

To take a pro-active approach to support with emotional and physical needs.

To provide patients with the opportunity to access a member of the specialist palliative care team and referral to appropriate services as needed.

To improve communication with the primary care team.

To explore the needs of patients and the interventions required to support them adequately.

To evaluate whether the model of care is effective for patients and professionals.

Conclusion Initial feedback is highlighting the benefits of the service to patients, carers and professionals. Both qualitative and quantitative data is being collected throughout the 9 month pilot study. This valuable information will help to inform decisions around the feasibility and effectiveness of the clinic for the future.