end of life services aptuk conference 2013
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End of Life Services APTUK Conference 2013. Lisa Wall-Hayes Specialist Medicines Management Technician, End of Life services Friday 7 th June. [email protected]. Hospice care. What is the first thing that springs into your head when you think hospice?. Palliative care. - PowerPoint PPT PresentationTRANSCRIPT
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End of Life ServicesAPTUK Conference 2013
Lisa Wall-HayesSpecialist Medicines Management Technician, End
of Life services
Friday 7th June
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Hospice care
• What is the first thing that springs into your head when you think hospice?
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Palliative care
• Traditionally mainly patients with a cancer diagnosis
• Now much more open to patients with other life limiting illnesses– Neurological diseases: Motor Neurone disease,
Multiple Sclerosis etc– End stage heart failure or renal failure– End stage COPD, HIV etc
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Hospice care• Most hospices have
– In-patient unit• Complicated symptom management• End of life• Respite
– Day Hospice services• Self management groups• Specialist days
– Community teams/ MacMillan nurses– Hospice at Home
• We also have a Multi-Disciplinary team
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Hospice care
• Only a tiny proportion of our patient are in-patients
• 14 bedded unit• 700 active patients currently known to the
hospice• Majority of our patients treated at home
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Preferred place of care/death• How or where would you like to die?• Not something we like to think about or talk
about• Statistics show that most of us if given the
choice do not wish to die in a hospital• The majority of people say they would prefer
to die at home or a hospice• However currently most of us die in a hospital
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Hospice vs. Hospital• Required to maintain standards as per hospital,
– CQC, Infection control, etc• We have a higher ratio of staff • Patients room within the hospice can be classified as
“temporary residence” so greater freedom allowed for patients and relatives
• More privacy and flexibility, e.g. – 24 hour visiting– Overnight accommodation for relatives– In-house chefs
• Specialist staff
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Infection control lead
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We don’t have one of these….
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We have one of these……….
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Clinical staff
Multi-Disciplinary Team (MDT)• Clinical Pharmacists• Occupational therapists• Physiotherapists• Social worker• Dietitians• Pharmacy technician
Other hospice staff• Clinical nurse specialists• Doctors• Psychotherapists• Art therapists• Counsellors/family support• Bridges (practical help)• Spiritual lead
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Technician wanted• 2 Clinical pharmacists providing specialist symptom
management / medication advice• Both pharmacists :Non-Medical Prescribers (NMPs)• Increased non-clinical workload, lots of medicines
management work• Who could replace the Medicines Management
Department of the PCT?• A pharmacy technician of course
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The job: Where do you start?• Legislative compliance• Policies• Audits• Cost savings• Accountable Officer support• Non-Medical Prescribing support• Research• Service development
• Medicines Information• Governance Committee• Training• Reports• Incidents• Clinical role• Specialist medication• Troubleshooting
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Clinical role• Day hospice patients• FAB clinic education
sessions• Medicines reconciliation• Home visits• Adherence issues
• Assistance with medication supply issues and prescriptions
• Mobile working in the community
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F.A.B-ulous patients
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“Medicines Matter”
• Monthly newsletter• Latest news • Audit results• Incidents• Questions• Did you know?
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Community Pharmacy “Specialist Palliative Care drugs” scheme
Background• A number of community Pharmacies have
been commissioned across the cluster to stock a specific list of palliative care drugs which will be available at all times during their opening times.
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Which palliative care drugs are being held by the pharmacies in the Birmingham
area?• Diamorphine ampoules 5mg, 10mg, 30mg, 100mg• Morphine sulphate 10mg & 30mg injection• Hyoscine butylbromide (Buscopan) ampoule 20mg/1ml• Levomepromazine (Nozinan) ampoule 25mg/1ml• Midazolam ampoule 10mg/2ml• Dexamethasone ampoule 4mg/1ml• Haloperidol ampoule 5mg/1ml• Alfentanyl ampoule 500mcg/1ml• Oxycodone ampoule 10mg/1ml• Cyclizine ampoule 50mg/1ml• Metoclopramide ampoule 10mg/2ml• Water for injection 10ml AND Saline for injection 10ml• Saline 1L bag for infusion
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How can we help?
“Every moment matters”
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What I had to learn quickly
•If it involves drugs in ANY way it’s my job and if it doesn’t it probably is too•You can’t fix everything•Everyday is a school day•Brown towels are better than red!!!•AND…………….
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Hospice staff
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PCPN, Palliative Care Pharmacy Network
• National organisation• Local networks for pharmacists• Google groups• Peer support
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Palliative Care needs
PHARMACY TECHNICIANS
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Thank you
Any questions?
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“Every moment matters”
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“ The question is not whether we will die, but how we will live”
Dr J Borysenko
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“As a well spent day brings a happy sleep so a
life well used brings happy death”
DaVinci
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“Every moment matters”