Dr Carmen Chan, a GP in training, and Dr Michael Tapley, Medical Director and Palliative Care Consultant at Willow Wood Hospice, Ashton-under-Lyne, UK, explain the background to their longer article published in the January/February issue of the European Journal of Palliative Care.
Being a GP (general practitioner) trainee has allowed me (Carmen Chan) to experience care from a number of different settings – from the first GP contact to admission through hospital Accident and Emergencies to the end of life care at home and in a hospice. I spent several months at Willow Wood Hospice, Ashton-under-Lyne, UK, as part of my GP training to gain experience in palliative care where I had the opportunity to work with and support the hospice team. I soon realised that many patients were here one week and gone the next, often dying within a few days of their inpatient hospice admission. I was already aware of the Hospice Transfer Project 1 and wondered if this had an impact on the length of stay.
The Hospice Transfer Project was jointly established between Willow Wood Hospice and Tameside General Hospital back in 2011. The aim was to identify the dying patient in the acute hospital setting and giving them the option of being transferred to the hospice for end of life care. I had first-hand experience of this project whilst working at the hospital and recognise the importance of the close relations and how easy it is for hospital teams to liaise with the palliative care team to arrange transfer to the hospice. The aim is to treat patients at end of life in a setting other than a busy acute medical ward; be it at home or at the hospice if they preferred.
At the hospice, we wanted to review the Hospice Transfer Project and see if patients were being correctly identified as dying and being transferred appropriately. When the project first started in 2011, there were 19 referrals over one year from the acute medical wards and this has grown to 114 inpatient admissions from medical wards from July 2015 to December 2015. We found that patients were being identified correctly as dying, hence this led to the average length of stay at Willow Wood Hospice being much shorter than the UK national average.
We explore this further in our article ‘A shorter average length of stay in a UK hospice – how is this happening?’ and share the experience of the Hospice Transfer Project several years down the line. Despite most inpatients having a short length of stay at the hospice, the hospice transfer project gives them the opportunity to die in a preferred setting with holistic care. Feedback from patients relatives included:
“helps all of us to remember Mum’s last days in such a caring and beautiful place” and “you made [patient’s name] last days comfortable and peaceful with the utmost dignity and respect,” which shows, despite the short stay, it has a positive impact for the patient and family.
- Tapley M, Pilling L, Jolley D, Daniels AM, El-Mahmoudi B. Hospice transfer for patients at the end of life: Part 1. Nursing Standard 28, 8, 42-48. October 2013.
This post relates to a longer article, ‘A shorter average length of stay in a UK hospice – how is this happening? by Carmen Chan, Michael Tapley, published in the January/February 2017 edition of the European Journal of Palliative Care (vol. 24.1). If you have a web-based subscription to the journal you’ll be able to download this issue, plus all articles in the journal archive.
You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online.
Read more posts relating to articles published in the European Journal of Palliative Care on the EAPC Blog.
EJPC Palliative Care Development Award 2017 – nominations form now online.
Do you know someone who has made a major contribution to palliative care policy development? Why not nominate them for the EJPC Palliative Care Policy Development Award? Click here to nominate. Launched by the European Journal of Palliative Care in collaboration with the European Association for Palliative Care, the award is aimed at professionals working in palliative care worldwide who have made a substantial contribution to policy development through research, clinical practice or as policy activists. The 2017 Award will be presented at the 15th World Congress of the EAPC in Madrid, Spain (18–20 May 2017). Deadline for applications: 31 March 2017.