North of England Cancer Network
Directory of Specialist Palliative Care Services
Document Information
Date of issue: October 2009
Review Date: October 2010
For more information regarding this document, please contact:
Sarah Rushbrooke
Nurse Director
North of England Cancer Network
Email:
Tel: 0191 497 1464
Team View
5th Avenue Business Park
Team Valley
Gateshead
NE11 0NB
Contents
Contents 3
Introduction 4
Hospices………………………………………………………………..5
Referral, Admission and Discharge Guidelines 6
Referrals for the Community and Hospitals 8
Specialist Palliative Care Team 8
Referrals for Specialist In-Patient Care 8
Referral for Specialist Palliative Day Care 9
Admissions 10
Discharge 10
Out of Hours Advice 10
Palliative Care Pathway 11
Facilities that Provide Specialist Palliative Care 12
North Cumbria 12
North of Tyne 14
South of Tyne 23
Durham and Darlington 29
Tees 32
Acknowledgements 39
Introduction
This directory is intended as a resource for all healthcare professionals who require information about all palliative care services available for cancer patients and their carers across the North of England Cancer Network (NECN). Each area within the Network has produced its own directory, either alone or in partnership with their neighbours but this single directory will guide you to the location and service you require wherever it exists within the NECN.
What is the role of the Specialist Palliative Care Team?
Specialist Palliative Care Teams influence patient care by a variety of means and the role encompasses clinical, consultative, teaching, leadership and research functions. The primary aim of the team is to bring about the highest standard of clinical care directly to the patient/carer by offering psychological support and expert advice on treatment options/symptom control or by indirectly acting as a resource to other professionals, who are likely to be the patient’s key worker.
What services do they offer?
Specialist palliative care providers offer specialist expertise in symptom control and holistic care to patients along with their families and carers.
Services available from specialist palliative care providers include:
§ Home visits
§ Domiciliary specialist palliative care
§ Outpatient consultations
§ Hospice in-patient palliative care
§ 24-hour help line
§ Specialist day-care
§ Lymphoedema management (separate guidelines available)
§ Ward consultations
§ Bereavement service / family support
Who provides the services?
Specialist Palliative Care Teams
At present specialist palliative care is mainly provided by the Consultants in Palliative Medicine and the Macmillan Specialist Palliative Care Nursing Services. The teams also include Physiotherapists, Occupational Therapists, Chaplains (religious/spiritual advisers) Dieticians and Social Workers.
The Community and Hospital Specialist Palliative Care Teams will assist the primary carer in assessing the needs of patients and relatives. They will not take over care; rather will act as a specialist resource.
Hospices
The Hospice Specialist Palliative Care Services are provided by the NHS and the voluntary sector. These services provide inpatient care, day therapies and outpatient facilities as well as many other complimentary services depending upon local needs. The teams referred to above, work closely with and may be part of the overall service provided from the Hospice. Specific local arrangements are detailed by locality.
Referral, Admission and Discharge Guidelines
GUIDELINES
Palliative Care is defined (NICE 2004) thus: “the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments”.
Specialist Palliative Care is delivered by professionals for whom the majority of their working role is in managing patients with palliative care needs. These professionals would therefore manage, or be advising in the care of, patients and their families whose needs are more complex, challenging, time consuming and refractory to usual input, and where this demand exceeds that which can reasonably be expected to be delivered by a professional whose main role is in another discipline.
Services available from Specialist Palliative Care Providers include:
· Community specialist palliative care
· Hospital specialist palliative care
· Hospice in-patient palliative care
· Specialist day-care
· Out of Hours Advice
The following referral / eligibility criteria are designed to provide clear guidance on how and when to refer to Specialist Palliative Care Teams. It is important to recognise that not all patients who have palliative care needs will require intervention from a Specialist Palliative Care Service.
A referral to Specialist Palliative Care Services can be made by any health or social care professional with the agreement of the patient and consideration of their preferred priorities of care. It is desirable that the patient is aware of their diagnosis / prognosis.
Referral should be made for:
· Patients with an advanced progressive illness, who additionally have uncontrolled symptoms, including pain, regardless of stage or outcome, over and above that which can be managed by the principal carers.
· Patients with an advanced progressive illness and their carers who require psychosocial support over and above that which can be provided by the principal carers.
· Patients with an advanced progressive illness and their carers who require spiritual support over and above that which can be provided by the principal carers.
· Patients with an advanced progressive illness requiring rehabilitation to enable them to adapt to the limitations of their condition and to maximise their quality of life.
· Staff requiring support in order to continue caring effectively for patients as outlined above.
CONTENTS OF A REFERRAL FORM / LETTER
Clinical details are required to allow appropriate assessment and prioritisation of the referral. Details requested include:
· Administrative details (name, age, address, date of birth, telephone number, NHS Number)
· Diagnosis
· Summary details of disease and treatment to date
· Outline of reason for requesting specialist palliative care help
· A list of current medications
· Service required
· Key workers already involved (GP, main consultant, nurse etc.)
· Telephone number of referrer
· Patient agreement to referral
Referrals for the Community and Hospitals
SPECIALIST PALLIATIVE CARE TEAM
The Specialist Palliative Care Teams influence patient care by a variety of means and the role encompasses clinical, consultative, educational, leadership, strategic and research function. The primary aim of the teams is to bring about the highest standard of clinical care directly to the patient / carer by offering psychological support and expert advice on treatment options / symptom control or by indirectly acting as a resource to other professionals, who are likely to be the patients’ key worker.
As this is not an emergency service the teams currently work 9am – 5pm, Monday – Friday.
Depending upon the reason for referral, and/or the needs of the patient / carer, four levels of intervention are available.
Level 1 - Advice, information and support may be given to professionals.
No contact with the patient by the Specialist Palliative Care
Team will be made.
Level 2 - Typically involves a single consultative visit, which may be a
Joint visit with the referrer, or an out-patient consultation. The
focus is advice to enable the primary carer to manage the
patient’s problems effectively.
Level 3 - Short-term interventions by the team in relation to specific
unresolved problems. The intention will be to discharge the
patient from the service back to the referrer when the patients
needs, in relation to the problems, have been resolved.
Level 4 - For those patients who will remain on the Specialist Palliative
Care Team’s caseload for a longer period or throughout the
disease process. Typically, patients needing this level of
intervention will have multiple problems that need specialist
input, or will have been referred at a late stage of the disease.
The Community and Hospital Specialist Palliative Care Team will assist the primary carer in assessing and managing the needs of patients and relatives. They will not take over care but will act as a specialist resource.
Referrals for Specialist In-Patient Care
Specialist in-patient units offer a comprehensive service provided by a multi-professional team 24 hours a day, 7 days a week. Patients referred often have unstable, complex and multiple needs, which have become difficult to manage at home. It is anticipated that the referrer will have sought advice from the appropriate community/hospital palliative care team prior to seeking specialist in-patient care.
Patients can be referred for:
· Symptom Management, including Pain Management
Complex symptoms, including pain, which cannot be managed in the patient’s current environment, which require regular assessment and monitoring.
· Psychological, Social and Spiritual Support
Complex psychological, social and spiritual issues, which cannot be managed in the patient’s current environment. An admission allows adjustment to the changes, which may accompany progression of the disease, allowing patients and carers the time required to come to terms with their condition and situation.
· Rehabilitation
Rehabilitation often follows a period in hospital or after palliative radiotherapy or chemotherapy, in order to assist individuals to adapt to the limitations of their condition and to maximise their quality of life.
· Care in the Last Days of Life
For some patients, it may be appropriate to admit for end of life care.
· Respite
Respite can be arranged on a non-urgent basis for a period of up to two weeks to allow carers a planned holiday or break. If the patients specialist palliative care needs cannot be met elsewhere. In exceptional circumstances it may be necessary to cancel or postpone a respite admission because of a more pressing need
Referral for Specialist Palliative Day Care
Specialist palliative day care operates between the hours of 9am – 5pm, Monday to Friday, with individual units opening on different days of the week.
Specialist day care provides:
· Assessment and regular review to help improve symptom control
· Access to the Specialist Palliative Care Multi-disciplinary Team
· Access to complementary therapies
· Respite care for the carer
Specialist day care promotes:
· Quality of Life
· Sharing of thoughts, experiences and fears with other people in a similar situation
· The reduction of social isolation
· The acceptance of diagnosis
· The achievement of realistic goals
Admissions
Admissions to individual Specialist Palliative Care in patient units should be made in accordance with locally agreed admission policies which are available from the individual hospices by telephone.
Discharge
Patients / carers will be discharged from the Specialist Palliative Care Service when:
· Their palliative care needs can be managed by their principal carers.
· The patient / carer moves out of the area
· The patient / carer no longer wishes Specialist Palliative Care Team input
Patients will be discharged from specialist in-patient care as soon as they can be managed by a non-specialist team with the appropriate specialist palliative care support.
All patients who have received level 3/4 interventions from a hospital specialist palliative care team should be followed a Specialist Palliative Care Service.
Out of Hours Advice
Healthcare professionals can seek Specialist Palliative Care clinical advice from Hospices across the North of England Cancer Network (NECN).
The NECN palliative care guidelines booklet, also available on the NECN website, provides details of contact telephone numbers.
Palliative Care Pathway
Facilities that Provide Specialist Palliative Care
North Cumbria
Locality Lead Contact: Janet Ferguson
Email:
Telephone: 079 7950 3897
Locality / Address / Telephone No. / Fax No.
North Cumbria / Cumberland Infirmary
North Cumbria University Hospitals NHS Trust
Carlisle
CA2 7HY
NHS Cumbria
Palliative Care
Workington Community Hospital
Park lane
Workington
CA14 2 RW
Hospice at Home
Carlisle & North Lakeland
c/o Eden Valley Hospice
Durdar Road
Carlisle
CA2 4SD
Eden Valley Hospice
Durdar Road
Carlisle
CA2 4SD
Hospice at Home
West Cumbria
Palliative Care
Workington Community Hospital, Park Lane
Workington
CA14 2RW / 01228 817148
01900705200
01228 603208
01228 810801
01900705200 / 01900606003
01228 603489
01228 817645
01900 606003
Specialist Palliative Care MDTs
Location / Schedule / Contact
Carlisle
Eden Valley Hospice
Durdar Road
Carlisle CA2 4SD / Weekly
Tuesday / 01228 603203
West Cumbria
Workington Community Hospital
Park Lane
Workington CA14 2RW / Weekly
Monday 9.30 / 01900705200
Carlisle and North East Cumbria
Lead Clinician: Dr Nick Sayer
Contact Details: 01228 603203
West Cumbria
Lead Clinician: Dr Eileen Palmer
Contact Details: 01900 705200
The following organisations are included within the locality:
§ North Cumbria University Hospitals NHS Trust
§ NHS Cumbria
§ Eden Valley Hospice
§ Hospice at Home Carlisle and North Lakeland
§ Hospice at Home West Cumbria
Specialist Palliative Care Team is:
§ Specialist advice available from team Monday-Friday 9-5
§ Palliative Medical team
§ Specialist palliative care nurses
§ Specialist Allied health Professionals
Specialist Palliative Care Services provided in area:
§ Eden Valley Hospice (12 in specialist beds)
§ West Cumbria, 6 NHS specialist beds
§ Consultant and medical team
§ Clinical Nurse Specialists
§ Specialist Social Worker
§ Bereavement service
§ Specialist Occupational therapists
§ Complementary therapies
§ Hospice at Home Nursing Service
§ Lymphoedema service
§ Marie Curie Nursing Service
§ Chaplaincy Service
§ Palliative Care Training Facilitator
§ Counselling
North of Tyne
Northumberland
Locality Lead Contact Paul Paes
Email:
Telephone: 0844 8118111
Lead Clinician: Paul MacNamara
Contact Details for Facilities and TeamsLocality / Address / Telephone No. / Fax No.
Northumberland / Northumbria Healthcare NHS Foundation Trust
North Tyneside General Hospital
Rake Lane
North Shields
NE29 8NH
Northumberland Care Trust
Merley Croft
Loansdean
Morpeth
NE61 2DL
North Tyneside PCT
Equinox House
Silver Fox Way
Cobalt Business Park
Newcastle upon Tyne
NE27 0QJ
Marie Curie Hospice
Marie Curie Drive
Newcastle
NE4 6SS
St. Oswald’s Hospice
(Adult and Children’s)
Regent Avenue
Gosforth
Newcastle upon Tyne
NE3 1EE
Tynedale Community Hospice
19-21 Battle Hill
Hexham
NE46 1BA
HospiceCare North Northumberland Castleside House
40 Narrowgate
Alnwick
NE66 1JQ / 0844 8118111
01670 394400
0191 2919292
0191 2191000
0191 2850063
01434 600388
01665 606515 / 0191 293 2745
01670 394501
0191 2919293
0191 2191099
0191 2848004
01434 600384
01665 606512
Specialist Palliative Care MDTs
Location / Schedule / Contact
Wansbeck General Hospital
Woodhorn Lane
Ashington
NE63 9JJ / Weekly need details
Tynedale Macmillan Service
St. Oswald’s Hospice – Adult Unit meeting room
Regent Avenue, Gosforth
Newcastle upon Tyne, NE3 1EE / Wednesday
St. Oswald’s Hospice – Adult Unit meeting room
Regent Avenue, Gosforth
Newcastle upon Tyne, NE3 1EE / Monday pm
St. Oswald’s Hospice – Children’s Unit
Regent Avenue, Gosforth
Newcastle upon Tyne, NE3 1EE / Tuesday pm
St. Oswald’s Hospice – Day Hospice and Day Treatment
Regent Avenue, Gosforth
Newcastle upon Tyne, NE3 1EE / Wednesday
Marie Curie Hospice
Marie Curie Drive
Newcastle Upon Tyne
NE4 6SS / Weekly
Beech : Wednesday p.m.
Cedar : Tuesday p.m.
Marie Curie Hospice – Day Care
Marie Curie Drive
Newcastle Upon Tyne
NE4 6SS / Weekly –
alternative days 9 a.m.
The following organisations are included within the locality: