P-105 End of life care at the weekend in a uk district general hospital

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Abstract

Background

In 2014 an independent review (Neuberger report) recommended discontinuation of the Liverpool Care Pathway. A subsequent report advised replacing the LCP with individualised end of life care plans, the contents of which were to be determined at local level.

Background

The Supportive and Palliative Care Team (SPCT) at a UK District General Hospital and Cancer Centre developed a Personalised End of Life Care Plan (PELiCan) encompassing the five key priorities of care (One chance to get it right). Each patient on the PELiCan is assessed daily by a member of the SPCT. This study aimed to assess the use of the PELiCan and the utilisation of a seven day SPCT service.

Methods

A database was created and every patient commenced on a PELiCan was entered. This database was retrospectively analysed over a 2 year period (1stSept 2014 and 31stAugust 2016). Descriptive statistics were used to assess demographic details and diagnosis. The day each PELiCan started was noted as well as the date of death or discontinuation.

Results

Nine-hundred and ten patients had an end of life care plan. The most common diagnosis was cancer (27%), followed by diseases of respiratory system (25%) and disease of circulatory system (16%).

Results

Twenty four percent (n=222) of patients with a PELiCan died on a Saturday or Sunday. Five hundred and thirty-two patients (58%) with a PELiCan were reviewed daily over the weekend. One-hundred and forty patients (15%) were started with a PELiCan during the weekend (Saturday n=56, Sunday n=84). Of these patients 34% had died before 9am on Monday morning.

Conclusions

A significant proportion of end of life assessment and support occurs at a weekend. There is a requirement for seven-day palliative care services to implement effective specialist end of life symptom assessment.

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