Communication and out of hours care
Providing effective care for palliative care patients, particularly as they become more ill or where needs are complex involves:
- An effective system to identify these patients in the practice. A palliative care register linked to a 'traffic light' system for example. Also see the criteria suggested in the Gold Standards framework for identifying cancer and non-cancer patients likely to be in the last year of life, who also need Palliative/Supportive Care. Gold Standards Criteria pdf
- An effective handover system from partner to partner and from doctor to nurse and MDT.
- An effective handover system from 'in-hours' to 'out-of-hours' care (and back again).
- Out of hours doctors/nurses trained to care for dying patients.
Out of hours doctors/nurses with access to written manuals or web-based
resources on dealing with common and predictable problems.
Anticipating and planning for common problems at home
Checklist for the last few days of life at home
Management of symptoms in the last few days of life
- Out of hours doctors/nurses with access to necessary equipment.
- Robust mechanisms for supply of out of hours medication with pro-active prescribing especially for high dose diamorphine.
- PRO-ACTIVE 'IN-HOURS' CARE: CRISIS AVOIDANCE
- Cumbria Just in Case Prescription Sheet
Please note that different areas will have different Out of Hours arrangements. See your area.
Palliative care communication pack 1 © Dr Eileen Palmer 2004