Experiences of 24-hour advice line services: A framework for good practice and meeting NICE guidelines

Abstract

This article presents a framework for the practical implementation of a 24-hour specialist palliative care advice line, illustrated by two case examples from the authors' experience. In the UK, National Institute for Health and Clinical Excellence guidance requires provision of 24-hour access to specialist palliative care advice for healthcare professionals and carers regardless of a patient's location. Effective implementation of a telephone advice line for specialist advice is one approach to addressing the current variability in palliative care service provision, both in the UK and elsewhere. The authors were unable to identify a model with documentation for ensuring adequate clinical governance of an advice line in the literature and so present their own. The accompanying case examples demonstrate the difference between 'evolution of services by demand' and taking a systemic approach to service design. Key recommendations for practice are outlined for an effective advice line service which incorporates training and education into the clinical governance structures of the host organization.

Telehealth in palliative care in the UK: a review of the evidence

“…1,12 Such a service would need to be provided in the long-term and there would need to be good communication pathways, training, technical support and workable protocols. 13–15…”

Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

“…Telephone out-of-hours service have also been used, either instead of, or as an adjunct to, existing palliative care services. [42][43][44] A systematic review of issues related to palliative care communication and telecare practice discovered that this has three dimensions. 23 Firstly, to reach high-quality care, HCPs have to build rapport with patients and family caregivers.…”

“…They argue that more realistic approaches to evaluation, using mixed methods, are required to improve the relevance of telehealth for service provision within the health care systems so that a workable and practical system can be achieved. 43 Other concerns from HCPs included issues about the legal status of telehealth, fear that the use of telehealth had added to their workload by disrupting normal practice, concern that the process was different from the protocol, and concern that misdiagnosis might be higher using telemedicine. 64 In linking telehealth to practice, there are important issues that should be taken into account, such as identifying existing clinical knowledge and practices and anticipating the ways in which these will be changed in incorporating the new technology.…”

State-wide telephone support: enhanced palliative care service delivery

“…Expert telephone advice can address some aspects of this variability. When effectively implemented, telephone advice services can aid the transfer of palliative care knowledge between specialists and generalists, and have been demonstrated to reduce hospital admissions by supporting healthcare professionals and carers in the community 3…”