Feb 1, 2022
This episode features Professor Scott Murray (Primary Palliative
Care Research Group, University of Edinburgh, Scotland, UK).
People living at home with advanced progressive illness require
well-coordinated services at all times of the day and night. Early
identification for generalist palliative care support and care
planning in the community can improve outcomes but requires
effective information sharing across services. People with
palliative care needs are high users of unscheduled care in the
last months of life.
People dying with advanced organ failure accessed unscheduled
community health services less often than people with cancer or
frailty. The organisation of unscheduled healthcare services is
poorly understood, and current care pathways could be used
more effectively in line with patient preferences. Early
identification and care planning in primary care of those requiring
palliative care informs and enhances their urgent and
emergency care
Better resourcing of unscheduled community services for people
identified for palliative care support in the community will
provide safer, more responsive, and cost-effective care. Rapid
access to unscheduled care via effective NHS telephone
services and out-of-hours primary care assessment can reduce
unwarranted ambulance calls, attendances at emergency departments
and hospital admissions. Public education should encourage and
support patients and carers living with advanced illness to access
the unscheduled care best suited to their needs. Routine clinical
datasets for most NHS unscheduled care services lack a
variable to record patients in the community identified for
palliative care.