Case study:

11 May 2010

Palliative Care Out of Hours Telephone Advice Line in Hull and East Yorkshire

Key points

A palliative care out of hours’ phone advice line for patients, families and healthcare professionals in Hull and East Yorkshire is helping patients to remain in their homes and be managed in their preferred place of care.

The service, which has been integrated into the roles of senior nursing staff within Hull and East Yorkshire Hospitals NHS Trust’s Oncology and Cancer Division, has led to excellent cross boundary working, helping patients and their families and avoiding the need for hospital admission at times of distress.

Out of the 156 callers in 2006, twenty four (15%) were admitted to hospital for justified reasons as inpatients and nine calls resulted in direct working with the Out of Hours Palliative Care Nursing service in the community, supporting patients to be cared for at home.

The service has been running for two years Leaflets about the service have been distributed widely and anyone can contact the pager number, leaving a name and contact telephone number.

The senior nurse on duty carries a Voda-phone pager at all times on their shift and when paged, responds to the call immediately.

She also has access to a resource folder, which is updated every six months.

On receiving the call the nurse completes the ‘contact form’ incorporating as much detail as possible, including the name and contact details of the GP, community Macmillan nurses and district nurses.

Any information and advice given to the patient and their family is then fed back to the relevant health care professional(s) the next working day.

This has promoted cohesive and seamless working with colleagues in the community and shows the patient that the relevant services are ‘talking to each other’.

If the nurse taking the call feels that face-to-face contact and assessment of the patient is required she will refer the patient to the community out of hours nursing service.

Where the patients’ problems have necessitated admission to hospital, this has been arranged directly to an oncology/palliative care ward wherever possible.

Staff have received appropriate education and training to ensure they are sufficiently competent and confident to deal with these calls.

In addition time was spent focusing on the difference between face-to-face support and telephone support.

In its first full year of operation, 2005, the service received 119 calls. In 2006 this rose to 156 calls.

It works very closely with the Specialist Palliative Care beds recently opened within the Hull and East Yorkshire Hospitals NHS Trust

Protocols for the service will be updated and reviewed on an annual basis.

Other areas have already expressed an interest in using this model to establish their own service.