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Oxford University Hospitals NHS Foundation Trust

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Community Palliative Care Team

Community palliative care aims to provide specialist support to patients within their own home (including care homes, nursing homes and wherever the patient may reside).

This specialist support may involve:

  • symptom control - we work with GPs and other healthcare staff to advise on medication and other help to improve difficult symptoms which are troublesome for patients
  • support for the individual and the people who are most important to them - this may mean referral to other organisations that can help
  • advice about benefits and other sources of financial support
  • support with planning for the future.

The team comprises nurses, doctors, occupational therapists, physiotherapists, a pharmacist and a benefits adviser.

All members of the team have specialist training and experience in caring for patients who have a life-limiting illness.

In Oxfordshire and South Northamptonshire, the Community Specialist Palliative Care Nurses work as one team, from two bases in the two hospices in the county - Sobell House in Oxford and Katharine House in Adderbury.

Community palliative care support is based on an in-depth assessment. As part of this we ask patients to complete a brief questionnaire, then explore concerns in more depth.

'Myth buster'

Referral to palliative care is not a 'secret code' that you are dying in a short timeframe - we see patients at any stage in their illness and are here to help improve quality of life

Referral to palliative care will not cause death - indeed, the evidence is that it not only improves quality of life but also that people who have palliative care involvement will live longer

Once referred, you are not a 'palliative care patient' - we often provide short-term support and discharge patients who can then be re-referred if things change and they need more support

Dying patients do not all need specialist palliative care referrals. All healthcare professionals have experience of caring for people who are dying. GPs and District Nurses have particular expertise, but sometimes things are complex and patients and families require more specialist support for a while

Palliative Care Hub

The Hub comprises doctors, nurses and administrators, and will take messages, answer queries and offer support and advice.

Contact the Palliative Care Hub

After referral to the Hub

After a referral, a Community Specialist Palliative Care Nurse will contact the patient / their advocate and check for urgent issues. We will arrange for an assessment appointment, usually with a nurse, sometimes with a doctor, or both.

This can be in person at the patient's home, a hospice or GP surgery, or virtual via Attend Anywhere or telephone.

At the end of the assessment, we develop a care plan with the patient and the people important to them. This can be reviewed at a later stage. With patient consent, we will share this with other healthcare professionals.

It is important to us to treat people as individuals, and enable them to live as well as possible in the time they have and achieve their own goals.

The patient's GP is responsible for care at home, requesting our palliative care advice when needed but remaining the key healthcare professional responsible for prescribing medication in the community.

The hospital team is responsible for any treatment that they advise. Some patients also have a Specialist Nurse linked to their condition who can offer support.

If a patient's symptoms improve, and they no longer need our support, we can discharge them from our service. However, if the situation changes, patients or their carers can contact us for advice, and be referred back to our service at any time.

Contact the Palliative Care Hub

Telephone

Tel: 01865 857036
Seven days a week 9.00am - 5.00pm

Out of hours (after 5.00pm) contact 111

We are not an emergency service: if your need is urgent call your GP surgery or 111.

They will have access to the right support and can contact the on-call palliative care doctor if necessary.

Patients currently under the care of the Palliative Care Hub should make 111 staff aware of this, as it can speed access to the right support.

Email

PalliativeCareHub@ouh.nhs.uk

Emails are checked every day. We do not give out individual emails or mobile numbers, as these are not checked when the member of staff is off duty.

When to contact the Hub

  • You have a question about your symptoms or advice the team has given
  • There has been a change in your symptoms. If this is a significant change we may advise a GP assessment. If you have a new symptom it is more likely we will advise you contact your GP
  • You want to change an arrangement you have made with a team member
  • You want to update a team member on your situation

When to call elsewhere

  • Out of hours call 111
  • For urgent help ring 999
  • For prescription renewal (even if originally advised by the team) - contact GP surgery
  • For District Nurses: 01865 903750

If the patient is in hospital or a hospice ward, please call the hospital or hospice for information, as the Community Palliative Care Team will not have up-to-date details

Electronic Patient Record

We use the hospital Electronic Patient Record (EPR) system to record all notes. These are confidential and kept securely.

For more information please visit:

Privacy Notice

Consent

We ask for your permission to share information with other professionals involved in your care. This is important so that we can provide you with the best possible care.

We will only discuss your care with your family, or others who are important to you, if you give us permission to do so.

We will only leave a message on an answerphone if you have agreed to this in advance.

Feedback

We regularly review and improve our care, and value your comments and suggestions.

For details of how to talk to someone outside the service, please visit:

Patient feedback

Last reviewed:21 October 2021