Transcript here - Scottish Partnership for Palliative Care

Choices and decisions
towards the end of life
Annual Conference 2014
#sppc2014
RCPE-WIFI
Password: chiron1681
Guidelines will be available in
October at:
http://www.palliativecareguidelines.scot.nhs.uk/
Guidelines can currently be viewed at:
http://www.testing29.scot.nhs.uk/

Evidence-based
clinical guidelines
supports the
provision of high
quality palliative care
by both specialists
and general staff.

NHS QIS to work
with Boards and SPPC
to agree a national
guideline for each
core topic and a
robust mechanism for
reviewing and
updating.

All Health Boards to
ensure that guidance
on all core topics is
made available


National Palliative Care Guideline project started
Supported by Scottish Partnership Palliative Care
(SPPC) and Healthcare Improvement Scotland (HIS)
Co-chairs:
Dr Paul Baughan, GP, Dollar and clinical lead NHS FV
Dr David Gray, Consultant in Palliative Medicine Accord
Hospice, Paisley


Aim to include a mix of professionals including
pharmacy, primary care and public representation
Choosing the Project Steering Group:
The Guideline Project Steering Group:
The Guideline Project Steering Group:
Not aiming for 29 sets of these:

HIS agreed to provide
methodological
advice

NES agreed to
provide librarian
support
June – August 2012 – 628 responses:
- highlighted many things liked in existing guidelines
- some areas that would like to see developed
- suggestions about formatting / accessibility




Pain Assessment
Pain Management
Neuropathic Pain Management
Choosing and Changing Opioids







Anorexia/Cachexia
Bowel Obstruction
Constipation
Diarrhoea
Hiccups
Nausea and Vomiting
Oral Care







Care in last few days of life
Complex discharge for end of life care
SC hydration
Emergencies – fits/ MSCC/Bleeding
OOH Handover Information
Uncontrolled severe distress
Last days of life - Renal Disease






Delirium
Depression
Hyercalcaemia
Pruritis
Sweating
Syringe pumps



Breathlessness
Weakness/Fatigue
Cough
Produced with support of Scottish Palliative Care Pharmacists Association















Alfentanil
Fentanyl Patches
Fentanyl Nasal Spray (Pecfent)
Fentanyl Sublingual (Abstral)
Fentanyl Buccal (Effentora)
Ketamine
Levomepromazine
Lidocaine
Methadone
Methylnaltrexone
Midazolam
Naloxone
Octreotide
Oxycodone
Phenobarbital (Phenobarbitone)



Internal review of initial guidelines
Each subgroup reviewed other subgroups’
work
Steering group meetings held at GMC
Outcome of Internal Review of Guidelines



Supported by Scottish Health Council /
SIGN User Involvement Officer
Meeting in Edinburgh with carers and
members of public
Helped to ensure focus and balance was
right

Co-ordinated independently by Dr Paul Keeley
Experts identified from around UK
Comments to subgroups
Each comment logged and considered

Final drafts to Medical Writers for readability






Paper presented to
national Directors of
Pharmacy
Letter sent to each
health board ADTC
recommending
adoption of guidelines
Some Health Boards
have already
approved, others still
to discuss
http://www.testing29.scot.nhs.uk/



HIS will take
ownership of the
guidelines
SHOW will host
App

HIS is developing a
light touch process to
ensure the currency of
the guidelines in the
future

Patient Information
update – a separate
project with
dedicated funding
and resources?
Electronic teaching modules for medical staff
Fiona Downs

http://www.testing29.scot.nhs.uk/guidelines/ab
out-the-guidelines/contributors.aspx




Familiarise yourself
with the guidelines
Discuss them with
colleagues
Refer to them for
clinical advice or
when teaching
Ask your health
board / MCN how
they are promoting
them
Choices and decisions
towards the end of life
Annual Conference 2014
#sppc2014
RCPE-WIFI
Password: chiron1681