Advocating Better Palliative Care At Home

AIMS

  • To raise public awareness and influence public policy regarding the need for better urgent palliative care in the community
  • To provide information and advice about choosing where to receive end-of-life care, and to enable those who prefer to die at home to achieve the best available care there
  • To support those providing emergency care at home for people seriously ill with Covid-19 (or other conditions) by identifying exemplary and poor practice
  • To identify and encourage areas of research

METHODS

  • Open letters to government and newspapers
  • Radio broadcasts
  • Blogs and evidence reviews on Oxford University’s Centre for Evidence-Based Medicine’s website
  • Contacts with palliative care providers and other campaigners
  • Talks and presentations
  • Development of decision tools and checklists
  • Links to relevant resources

PALLIATIVE CARE AND COVID-19

Palliative care, the alleviation of symptoms, has been an important aspect of medical practice since time immemorial.

The last fifty years have seen the development of palliative care specifically to manage end-of-life situations. We celebrate this and applaud the palliative care community’s continuing work to improve the quality of, and access to, this service in all settings – hospitals, homes (both domestic and institutional) and hospices.

However, providing palliative care in the community during a pandemic of a new virus is extremely challenging. The Covid-19 pandemic has highlighted difficulties in getting access to timely, sometimes urgent, palliative care for those people who, for whatever reason, are obliged or prefer to stay at home. Patients need to be diagnosed in their home, then provided with the necessary medication, equipment, care and reliable advice, while avoiding transmission of the disease.

In drawing attention to these challenges and pressing for effective responses to the current crisis, we hope that palliative care services in the community will be better prepared for the future, both in more normal times and in times of further possible pandemics.

Advance Care Planning and Emergency Palliative Care Access

Following the success of the vaccine rollout and the closure of the Covid-19 palliative care rapid review panel at CEBM we have been concentrating on Advance Care Planning (ACP) as a way to ensure emergency responders are aware of the wishes of those who would prefer to stay at home. To this end we have written our own ACPs and developed a template with the help of our ACP adviser Sophie Thomas. We have also started an ACP support initiative in Bucks to help people without a life-limiting diagnosis to make a plan. If you wish to make a plan, please visit our ACP support page for advice.

We are also exploring models of emergency palliative care provision around the country with our partners – Chiltern Compass – and will comment at a later date.