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Oxford University Hospitals NHS Foundation Trust

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Thank You - Palliative Care Teams

31/07/2020

Palliative Care involves caring for people at the end of their lives, managing pain and other physical and psychological symptoms, and keeping them as comfortable as possible.

This includes attention to emotional, social and spiritual distress - and supporting those important to them.

Our Palliative Care Teams bring together specialist expertise from many backgrounds, such as medical, nursing, allied health professionals, pharmacy, therapists, social work and chaplaincy. These professionals work closely with the staff directly caring for our patients, in hospital or in the community. 

COVID-19 brought with it some heart-breaking challenges - not least the difficult conversations that had to be held with patients from behind a mask, and with their families over the telephone, rather than in person.

There were major organisational challenges, too.

The Sobell House Hospice Palliative Care Team increased their staff numbers to ensure everyone had the advice and support they needed, with contributions from skilled colleagues in Oncology, Katharine House Hospice in Banbury and Helen and Douglas House in Oxford - all hugely appreciated. 

The Hospital Palliative Care Team kept pace as wards were continually adapted to accommodate changing numbers of COVID-19 positive patients. 

Out in the community many patients were 'shielding' so our Community Palliative Care Team had to change their practice considerably, initially moving to a telephone service, and then to virtual consultations with 'Attend Anywhere', and home visiting with personal protective equipment (PPE) where needed.

Staff began working from home, new electronic systems were set up and the community service continued with barely an interruption. As 'lockdown' continued, home assessments increased: the team became used to 'donning' and 'doffing' masks, aprons and gloves outside patients' homes. 

Along with other specialist teams, a 24-hour end of life care telephone line was set up for healthcare professionals in Oxfordshire, including care home staff. 

Sobell House Hospice saw many changes, not least restrictions on visiting. Patients' families were very understanding, and staff worked hard to keep them involved and up-to-date with daily telephone calls.

Physiotherapists and Occupational Therapists continued to visit patients in their own homes (fully equipped with PPE) to ensure they had the right equipment and knowledge to maintain their quality of life. Therapists on the ward continued to provide the rehabilitation that enabled patients to get back to their families.

Mindful that patients and families might not be contacting healthcare services due to the crisis, the Sobell Voluntary Service began a 'Telephone Check-in' system with weekly or fortnightly calls to known patients and clinical staff alerted of any concerns.

The Sobell Bereavement Service continued to provide support and counselling throughout, with volunteers working over the telephone: they now offer video calls, for those families who prefer to see a friendly face.  

All of this was achieved with the help of incredibly flexible administration teams, providing support where it was most needed; in reception, on the ward and on the telephones.

The Palliative Care Service is supported by the Sobell House Hospice Charity, which has always been there for us, raising funds and providing the thoughtful little gifts and snacks that made our staff feel so valued.

Professor Bee Wee, Clinical Lead for Palliative Care, says:

"I am privileged and honoured to work with such amazing colleagues. They have risen with courage and commitment to the challenge of coping with the impact of COVID-19 professionally and personally..., with good heart and in so many different ways.

"Working with such colleagues is truly uplifting."

Professor Meghana Pandit, OUH Chief Medical Officer, says:

"Our Palliative Care Service is so important to us - compassion and excellence in patient care is at the heart of everything we do. We are very proud of the team."

"Our Palliative Care Team has worked incredibly hard to continue to support our patients and their families through this very difficult period, and in providing expert support to other staff looking after our patients."

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