Background Bolton NHS Foundation Trust serves a population of approximately 260,000. Specialist palliative care services are integrated between hospital, community and Bolton Hospice. Seamless care for patients is dependent on collaboration between these specialist services and community services provided by primary care and district nursing services.
Objective To improve services for palliative patients and those at end of life by implementing weekday community liaison meetings attended by the Hospice Liaison Nurse, Community Palliative Nurse Specialist, District Nurse neighbourhood representatives, AHPs, Social Worker and Community Consultant. Meetings are face-to-face and held at Bolton Hospice with a set agenda and prompt start and finish. Meetings typically last 30 min.
Outcomes 160 patients were discussed in detail in the first six months of the project. Of these 113 died: 54 at home, 46 in the hospice, nine in hospital and two in residential or nursing homes. Meetings resulted in improved communication, decreased repetition of work, peer support, appreciation of alternative professional perspectives and care from the right professional at the right time. A number of patient stories illustrate the value of the meetings.
Discussion Daily community palliative care meetings can enhance communication and care for patients and may contribute to efforts to fulfil the wishes of patients and carers at end of life. This in turn may help to reduce unnecessary hospital admissions. The use of technology to facilitate remote attendance will improve efficiency and staffing costs. Improved IT and clerical support will allow communication of outcomes to other healthcare professionals such as out of hours services. Seven day liaison meetings may be implemented alongside further review of seven day specialist palliative care services.
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