Palliative care in the acute hospital setting A practical guide

Hospital palliative care teams have been established in rapidly increasing numbers over the last 20 years, as it has been recognised that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; they often work as 'stand alone units' and remain outside mainstream medicine. However it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there. Based on the extensive experience and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with practical guidance and down to earth advice on a range of problems they might encounter. Using a problem focused and practical approach, Palliative Care in the Acute Hospital Setting: a practical guide is filled with case-based problems to help readers identify realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help them continue to flourish. Written in an accessible style with short and focussed chapters, this clearly laid out book helps readers find the information they need to tackle particular problems easily and with confidence. With a supportive outlook and covering the non-clinical management aspects of palliative care, this book is the ideal guide for palliative care specialists making the transfer from hospice to hospital, and for those setting up palliative care teams in the acute hospital setting.

1. Palliative care in the acute hospital. 2. Getting started: structure and function of the team. 3. Organising clinical care. 4. Being part of the mainstream in the acute hospital. 5. Multidisciplinary working in practice. 6. Bureaucracy and money. 7. Education in the acute hospital. 8. Training issues in palliative medicine. 9. Research in the acute trust. 10. Personal survival. Appendix 1. Appendix 2.

Dr Sara Booth trained in palliative care at St Christopher's Hospice in London and Sobell House in Oxford. After holding an NHS R&D Training Fellowship at the Oxford Radcliffe Trust, she moved to Cambridge in 1998 to set up a hospital palliative care service and has continued research in Breathlessness and evaluating a Breathlessness Intervention Service which she founded there. She is Honorary Senior Lecturer in the Department of Palliative Care and Policy at Kings College London, and Associate Lecturer in the University of Cambridge. Polly Edmonds is a consultant and lead clinician in Palliative Medicine at King's College Hospital NHS Foundation Trust and honorary clinical senior lecturer in the Department of Palliative Care, Policy & Rehabilitation, King's College London. She qualified from St Mary's Hospital Medical School, and trained in General Medicine, Medical Oncology and Palliative Medicine prior to taking up her consultant post in 1997. She has led the development of the clinical Palliative Care Team at King's and is closely involved in the undergraduate curriculum at the King's College London School of Medicine, as Palliative Medicine teaching lead, deputy head of year 4 and year 4 OSCE coordinator. Jointly with Dr Rachel Burman, Polly is training programme director for the London and KSS Deanery Specialty Training Programme for Palliative Medicine. She has previously chaired the Southeast London Palliative Care coordinating Group of the South East London Cancer Network and remains an active participant. Margaret A Kendall is a Macmillan Consultant Nurse in Palliative Care employed by Warrington and Halton Hospitals NHS Foundation Trust. She took up this post in 2001 although her clinical career in palliative care began in 1989 with her appointment as a Macmillan Clinical Nurse Specialist in the Merseyside area. She is an Independent Nurse Prescriber since 2003 and hold outpatient clinics twice weekly. She has been involved in consultations on the nursi