What we do
Palliative or end-of-life care is care that helps all those with advanced, progressive, incurable illness to live as well as possible until they die. It enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last year(s) of life and into bereavement. It includes management of pain and other symptoms and provision of psychological, social, spiritual and practical support and is applicable to care given in all settings.
Referral to the team should be considered for the following:
- patients (within Bradford Royal Infirmary and St Luke’s Hospital inpatient/outpatient setting) who have active or advanced and progressive disease for whom the prognosis is limited (although it can be several years)
- where one or more of the following needs are unmet:
a) symptom control
A symptom which:
- is not responding to current interventions
- seems to be causing overwhelming distress to the patient or the family, at any point during an admission
- is not commonly encountered or is known to be difficult, such as hiccup, tenesmus, pelvic pain, itch, incident pain, neuropathic pain
b) psychological and spiritual support
- patients or carers who appear to be struggling psychologically or emotionally with the illness or physical condition, and seem to need more support than can be provided by the professionals currently involved in their care. Alternatively a referral to a psychologist for specific psychological interventions or to the chaplaincy team may need to be considered.
c) social support
Patients with children under the age of 18, particularly if it appears the children are unaware of the nature of a parent's illness.
- patients in whom a family member or carer is felt to be a significant bereavement risk
- families within which there appears to be a conflict of interests which impinge on the coping strategies of the patient or the carers.
- complex social issues including guidance on advance care planning.
d) assessment for hospice care
- any patient who the ward staff or the patient’s carers feel would benefit from hospice care. This may be for specialist symptom control, active rehabilitation or terminal care. The hospices also offer day care facilities
e) Assessment for future care
- difficult decision making about appropriate future place of care
f) Hospital Staff support
- for staff dealing with difficult situations or for debriefing following a death.
The team offer an advisory service and will work closely alongside the admitting consultant and ward staff who retain clinical responsibility. Urgent referrals will be dealt with within one working day. Routine referrals will be dealt with within two working days.
All consultations are recorded in the medical notes and the patient electronic record.
Clinical Review Meeting (CRM)
This is held every Tuesday morning. All newly referred patients are discussed based on the initial holistic assessment as recorded on the patient electronic record. Current patients or patients discharged/deceased since the last CRM will be reviewed. The date of discussion, problem identified and any decision or recommendations made will be recorded on the patient electronic record. The identified palliative care keyworker (or nominated representative) is responsible for presenting, implementing and/or communicating action points agreed.
Patients and/or carers with highly complex needs will be discussed at the locality specialist palliative care MDT. This is held fortnightly. Core membership of the locality MDT includes representatives from each of the specialist palliative care providers across the Bradford district.
- Dr Andrew Daley Consultant in Palliative Medicine (Lead Clinician)
- Liz Price Macmillan Clinical Nurse Specialist in Palliative Care
- Sam Rowell Macmillan Clinical Nurse Specialist in Palliative Care
- Trudy Nurse Macmillan Clinical Nurse Specialist in Palliative Care
- Charlotte Rock Macmillan Clinical Nurse Specialist in Palliative Care
- Paul Fernandez Last Days of Life Educator
- Specialist Registrar Personnel in this training post change every six months
- Wali Nazir Ethnic Minority Liaison Worker
- Tasleem Begum Medical Secretary
Referral or advice: 01274 364035
The team are based at: Room 103, C Floor, Field House Bradford Royal Infirmary
Out of Hours Service
Outside normal working hours, the ward team looking after you can telephone the palliative care consultant on-call for advice at any time if you need it.