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37 The use of personalised end of life care pathway at the royal surrey county hospital
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  1. Helen Thomson and
  2. Katherine Webber
  1. Royal Surrey County Hospital

Abstract

Introduction National guidance has recommended locally developed personalised care plans to ensure needs are met as patients are approaching end of life. The Royal Surrey County Hospital (RSCH) has developed a Personalised End of Life Care Plan (PELICan). This aim of this project is to assess the use of PELICans in a District General Hospital and Cancer Centre over a three year period.

Methods A database was created of all patients with a PELICan at the RSCH over a three year time period (1/9/2014–31/8/2017). Outcome measures included start date of PELICan, presence of PELICan over a weekend and length of time on PELICan before death or discontinuation.

Results 1378 patients had a PELICan over three years. There was an increasing number of patients placed with a PELICan every year (53%, 55% and 62% in successive years). The mean time a patient was cared for with a PELICan before death or discontinuation was 4.5 days (range 1–169 days). Only 7% of PELICans were discontinued over three years, with 71.4% being stopped in the first seven days. 16.8% percent of PELiCans were commenced over the weekend, with this number increasing every year (14.5%, 16.0% and 19.6% in successive years). Of those patients who died with a PELICan, 27.2% died on a weekend.

Conclusion The use of the PELICan is increasing at the RSCH. There has been the introduction of a seven day Palliative care service at the RSCH, which is imperative when considering the proportion of patients dying with a PELICan, as well as those dying on a weekend. Physicians are quite accurate with their prediction of death within the next seven days. The PELICan booklet at the RSCH requires a daily multidisciplinary review, and consequently, most of the PELICans that are discontinued are done so early on.

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