The impact on community palliative care services of a hospital palliative care team

Abstract

This retrospective study examined the influence of a hospital palliative care team on the activity of a local hospice home care team over a four-year period from May 1989 to April 1993 in East Leeds. The increasing referral to death interval observed in home care patients over this period appears to be due to the presence of the hospital team. The increasing work-load of the home care team generated by the hospital team is discussed with reference to solutions to meet this increasing demand. A district or regional planning strategy is recommended to co-ordinate existing and potential palliative care services.

End-of-Life Care: Lessons from Other Nations

“…Costs of hospice and palliative care and constrained by contracts within the NHS and the ability to raise charitable funds, although the NHS more often supports hospital based teams and so these are often well integrated. 45 But the fact that patients can still obtain care from hospitals and other community services, and alongside hospice and palliative care, means that the more intensive therapies, such as chemotherapy, radiotherapy, transfusion and more expensive treatments such as bisphosphonates for bone pain and hypercalcaemia, to improve symptoms or enhance life, can be given alongside other treatments. [46][47][48] There is also a growing emphasis on providing rehabilitation in hospices and palliative care services.…”

The new NHS and the independent hospice sector

“…For example, hospital-based palliative care teams can get more cancer patients into the community. 5 However, resources might be diverted, for example from specialist palliative care services to provide nurse specialists for general practices. It is crucial that the recommendations of the NHS executive which discourage diversion of funds away from existing high-quality palliative care services should apply to primary care groups.…”

The current status of palliative care teams in Japanese University Hospitals: a nationwide questionnaire survey

“…The number of palliative care units (PCUs) has dramatically increased from five in 1990 to 135 in 2004. To be certified by prefecture's authorities, a PCU for cancer or HIV/AIDS patients must fulfill certain conditions: (1) staffing must include at least one full-time physician and a sufficient number of nurses; (2) physical facilities must be adequate and include such features as floor space around the beds, rooms for socialization, family rooms, etc. ; and (3) the hospital itself must be certified by a Japanese hospital quality assurance system, such as the Japan Council for Quality Health Care (JCQHC).…”

“…Hospital-based PCTs have been developed and evaluated in many Western countries [1,3,4,6,7,10,12]. In addition, PCTs in university or teaching hospitals have been described and their roles have been evaluated [8,14,18,19].…”

“…The aims of this paper are: (1) to clarify the 2005 status of PCTs in Japanese university hospitals, (2) to compare factors characterizing hospitals which use PCTs vs those that do not use PCTs, (3) to compare certified PCT and noncertified PCT programs in terms of content of care, and (4) to describe the evolution of the PCT program in Japanese university hospitals over the 3-year study period.…”