End of life care at University Hospital Bristol
The ombudsman’s report found instances nationwide of poor end-of-life care adding to the distress of patients and their families, with problems including poor care planning, poor communication, poor symptom control, and a lack of recognition that people are dying and a failure to respond to their needs.
By contrast, UH Bristol’s supportive, palliative and end-of-life care team’s service was rated good in the Trust’s Care Quality Commission’s report last December, and identified as providing a caring, responsive, well-led, safe and effective service.
The CQC’s report said: “The specialist palliative care team was innovative and adapted to local needs and national policy by continually developing and evaluating tools and training to promote good end-of-life care for patients. The team shared its knowledge and learning within the trust and published its research. The team’s responsiveness, support and skill were highly regarded by colleagues throughout the trust. The team was established in wider palliative care networks, including the local hospice and clinical commissioning group.”
Sophia Bloor, joint lead nurse for supportive, palliative and end-of-life care, said: “We know that early communication of patients’ prognoses provides a better opportunity for good end-of-life care to be put in place. We’ve done a great deal of work at this Trust on identifying patients at an earlier point in their illness, so we can put support in place for them as soon as possible. There are also a lot of processes in place to ensure that a patient’s prognosis is communicated to them properly, and that they understand it.
“As an acute hospital trust, our approach to end-of-life care comes from a slightly different angle. For us, the focus is on ensuring patients have a good death, rather than where they die. While it’s vital that we do what we can to discharge patients to their preferred place of death, it’s about making sure that if patients die while they’re at UH Bristol, they have as good a death as possible.”
Jo White, joint lead nurse for supportive, palliative and end-of-life care, said: “Working closely with the staff who look after these patients day-to-day is an essential part of that, so to that end we’ve recruited and trained 30 ward-based nurses to be end-of-life care link nurses. Good communication, education and training for staff around end-of-life care is essential, and it’s something we’re continually working on. We believe that every moment counts for patients, relatives and carers and therefore delivering high quality end-of -life care Trustwide is essential.”
The team has also piloted focus groups for bereaved relatives, enabling them to give feedback about the care their relative received. The feedback gathered from these sessions allows the team to refine elements of their service, or make changes and improvements to practice across the Trust if required.
