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P-219 The earlier the better: early referral to palliative care improves quality of life
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  1. Sue Eskins,
  2. Becky Avery,
  3. Lynn Porch and
  4. Sarah Parkes
  1. Dorothy House Hospice Care, Wiltshire, UK

Abstract

Background In 2014 the WHO declared that ‘early palliative care not only improves quality of life for patients but also reduces unnecessary hospitalisation and use of health care services’. Following an audit in 2014 the Contact Centre at our hospice were aware that there were a number of patients who would benefit from our services but were either declining the services or being declined due to not being able to meet the criteria for specialist palliative care and end of life care.

Aims To develop an early palliative care service which allowed the patients and families/carers to experience a modern hospice approach of living well and palliative reablement. This included:

· Advance care planning

· Early support for families and carers

· Networking with other agencies e.g., CAB, carers support

· Live well approach

· Opportunity for referral to hospice services to prevent crisis e.g., 24 hour advice line, H@H

· Psychological support.

Methods · Outpatient style appointment at an Outreach Centre close to home at the patient’s/family convenience with a named nurse.

· Patient centred approach

· Referral to other internal and services

· Flexible approach to use of hospice services.

Results · Significant increase in the number of patients/families gaining access to hospice services

· Extension of lighter touch services

· Increase in referrals of non-cancer and long term conditions

· Positive feedback from patients/families

· Earlier referral for some patients to complex specialist services

· Development of the nursing team’s skill mix

· De-stigmatises hospice care.

Conclusion · Further investment in the early referral services as patients and families/carers are utilising living well and palliative reablement services

· An opportunity to encourage end of life conversations and advance care planning for patients with dementia

· Potential to extend into GP surgeries/satellite clinics to reduce anxiety around being referred to a hospice

· Potential to extend into outpatient services at local hospitals to support patients who are newly diagnosed as palliative.

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