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126 Using palliative performance scale (PPS) and phase of illness tool (POI) to facilitate improvement in communication of palliative care needs across health and social care
  1. Claire Howie,
  2. Marianne MacLeod,
  3. Monica Keenan and
  4. Kim Steel
  1. NHS Fife


Background In 2018, the NHS Fife Specialist Palliative Care team were awarded funding to spread the learning form the Macmillan funded TCAT ‘Best Supportive Care in Lung Cancer’ project. Communication barriers and imprecise language existed across our health care environments was one of the factors that had been identified within the Lung Cancer Best Supportive Care project, that needed improvement and this second phase of the project gave us this opportunity.


  • Process map the ‘hand-offs’in communication between professionals that occur from the bedside assessment in hospital to having a professional assessing again in normal place of residence;

  • Teaching and feedback at all points identified in the process-map;

  • Quantitative assessment of how many patients discharged by palliative care occupational therapy team were re-admitted within 14 days and how many died in normal place of residence;

  • Qualitative interviews with professionals involved at the discrete points of the process map to describe the changes made to practice.


  • There was a change in response from the discharge assessment team;

  • More patients were discharged home and died in their normal place of residences;

  • There was an increase in the number of discharges home of patients known to the Specialist Palliative Care Occupational Team;

  • The themes from qualitative analysis included the benefit of common language and sense of urgency that came across from describing the changes in PPS and POI over a period of time.

Conclusions Palliative Care Performance Status and Phase of Illness can be implemented across an acute hospital and can aid transitions to discharges. It improves communication of the patients needs, health and carer status. As communication underpins all we do the need for accurate, reproducible, evidence based descriptors is important to keep patients safe and to advocate for their needs.

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