PowerPoint Presentation

Choices and decisions towards the end of life

Annual Conference 2014

RCPE-WIFI Password: chiron1681

#sppc2014

Scottish Palliative Care Guidelines Launch

Ready to set sailhttp://www.palliativecareguidelines.scot.nhs.uk/Guidelines will be available in October at: Final sea trialshttp://www.testing29.scot.nhs.uk/Guidelines can currently be viewed at: Policy background

Evidence-based clinical guidelines supports the provision of high quality palliative care by both specialists and general staff.2 Actions:All Health Boards to ensure that guidance on all core topics is made available

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.

Guideline Development Process2012National 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 FVDr 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:9

The Guideline Project Steering Group:10

The Guideline Project Steering Group:

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Not aiming for 29 sets of these:12Methodological Rigour:HIS agreed to provide methodological advice

NES agreed to provide librarian support

Survey Monkey:

June August 2012 628 responses: - highlighted many things liked in existing guidelines - some areas that would like to see developed - suggestions about formatting / accessibility

Subgroup 1- PainLeads: Sheila Scragg and Fiona SneddonPain AssessmentPain ManagementNeuropathic Pain ManagementChoosing and Changing Opioids

15SG 2 Gastro-intestinal careLeads: Tim Morgon and Alison MacRobbieAnorexia/CachexiaBowel ObstructionConstipationDiarrhoeaHiccupsNausea and VomitingOral Care

SG 3 End of Life and EmergencyLeads Rosalie Dunn and Sandra McConnell

Care in last few days of lifeComplex discharge for end of life careSC hydrationEmergencies fits/ MSCC/BleedingOOH Handover InformationUncontrolled severe distressLast days of life - Renal Disease

SG 4 Psychological and MiscellaneousLeads: Claire Sharp and Karen MenziesDeliriumDepressionHyercalcaemiaPruritisSweatingSyringe pumps

SG 5 Respiratory CareLeads: Fiona Downs and Shirley KellyBreathlessnessWeakness/FatigueCough

Medicines Information SheetsProduced 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)

Subgroup Initial drafts:Internal review of initial guidelinesEach subgroup reviewed other subgroups work Steering group meetings held at GMC

Outcome of Internal Review of GuidelinesSupported by Scottish Health Council / SIGN User Involvement OfficerMeeting in Edinburgh with carers and members of publicHelped to ensure focus and balance was right

Public and User Focus Group:External Review

Co-ordinated independently by Dr Paul KeeleyExperts identified from around UKComments to subgroupsEach comment logged and considered

Final drafts to Medical Writers for readabilityArea Drugs Therapeutics Committee ApprovalPaper presented to national Directors of PharmacyLetter sent to each health board ADTC recommending adoption of guidelinesSome Health Boards have already approved, others still to discuss

Open consultation

http://www.testing29.scot.nhs.uk/AccessibilityHIS will take ownership of the guidelinesSHOW will hostApp

The FutureHIS 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 staffFiona Downs

Thank you to all who contributed http://www.testing29.scot.nhs.uk/guidelines/about-the-guidelines/contributors.aspxHow can you help?Familiarise yourself with the guidelinesDiscuss them with colleaguesRefer to them for clinical advice or when teaching Ask your health board / MCN how they are promoting them

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Choices and decisions towards the end of life

Annual Conference 2014

RCPE-WIFI Password: chiron1681

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