Case study:

11 May 2010

Rapid response palliative care clinic in Hull and East Yorkshire Hospitals Trust

Key points

A rapid response pain and symptom control clinic has been set up in Hull and East Yorkshire Hospitals Trust to help palliative care patients remain at home for as long as they wish during their patient journey and at the end of life.

The nurse-led sessions take place each Friday morning and involve a holistic assessment of the patient’s needs with any follow-up treatment conducted as soon as possible thereafter – often on the same morning.

All patients are then given a silver credit card with details of access to 24-hour specialist palliative care phone support.

They are also encouraged to contact the team for ongoing support and advice.

The clinic is run by two clinical nurse specialists, a clinical support worker and a medical secretary.

Patients are given a 30-minute appointment. After a management plan has been formulated the independent nurse prescriber prescribes any medication required.

A specialist registrar in palliative care provides a medical assessment where needed and if palliative radiotherapy is required this can often be undertaken on the same morning.

Clear explanations of the management plan are given to the patient and their carer and are reinforced with written information.

The clinic runs in conjunction with a physio/nurse led breathlessness clinic (for all palliative care patients with dyspnoea) and a rapid access clinic for patients with lung cancer, which is led by a consultant palliative oncologist.

On completion of the clinic session a fax proforma, including details of any prescribed medication or treatment, is faxed to the patient’s GP.

An evaluation of the service is currently under way.

There are already plans to introduce an additional session because the clinic has proved so popular.

And it is hoped to develop a satellite service in the community using the same model.