With the support of Irish Hospice Foundation, I was one of the recipients who attended the inaugural SPICT International Conference held last 2nd of February 2018, hosted by the University of Edinburgh. The event was represented by 95 delegates from different countries, disciplines, care settings and healthcare systems.
SPICT stands for Supportive and Palliative Care Indicator Tool. The tool is used to help identify people whose health is deteriorating, assess them for unmet supportive palliative care needs and plan of care. The event highlighted innovation in identifying palliative care needs, care planning and a review of the evidence based across different settings.
“The tool simplifies the identification of people at ‘risk ‘of deteriorating who can benefit from holistic needs assessment and care, by simply using the SPICT tool clinical indicators of major advanced conditions such as cancer, dementia/frailty, organ failure, neurological conditions and other conditions with limited reversibility. Given the SPICT tool is applicable for all the healthcare settings, it doesn’t predict an accurate prognosis for an individual patient, but rather is a very useful resource that supports the healthcare professionals to recognize palliative care needs at an early stage. It promotes impeccable assessment which may potentially improve palliation and quality of life of people with limiting illness”.
Professor Scott Murray of St Columba Primary Palliative Care, initiated the conference with his vibrant and interactive presentation about early palliative care. He also highlighted the world mortality rate, the reality that patients are dying in all settings and that nearly everyone needs palliative care due to their life threatening illness. He also made a huge emphasis that early palliative care must be provided to these 5A’s: “All illnesses, All times, All dimensions, All settings and All nations.”
Professor Kirsty Boyd, Honorary Clinical Senior Lecturer in University of Edinburgh, discussed SPICT as a global tool to identify people who require palliative care through advance and anticipatory care planning; from the start, to the diagnosis of new serious illness and continuing on during the deterioration of their health to old age. Professor Boyd’s take home message was a quote from R.W. Emerson “it is not the length in life, but the depth in life” summarizes everything about palliative care. It is about helping people to find meaning while they are still alive, to live until they die and become a loving memory for those that matters to them.
Ireland’s very own pride, Dr Brendan O’Shea also presented a pilot study in 4 GP training practices in Ireland using the SPICT tool with the end of life planning tool, Think ahead. Think Ahead was developed by the Irish Hospice Foundation to help members of the public to talk about and record their preferences in the event of emergency, serious illness or death. The study has concluded the two tools work well together and achieved participation from patients and their family. Participants (74%) reported they did not find the Think Ahead form upsetting and the remaining participants (26%) reported partly upset in terms of discussing their care preferences and talking about death.
The 6 workshop presentations took over the second part of the conference. Steps on how to access the SPICT tool, translation of SPICT in different languages and the application of SPICT in the community and acute setting was widely discussed.
With the expertise of Bruce Mason, he presented the algorithm using ANTICIPAL and SPICT at identifying patients likely to have early palliative care (anticipatory) needs. Every workshop session encapsulates the greater necessity to use the SPICT tool in all healthcare settings in response to changing health patterns, the increasing ageing population and the increasing demand for end of life care provision in care homes and the community (Bone et Al, 2017).
Overall, it was an honour to receive a first-hand education from such respectable presenters. The event delivered a great sense of camaraderie and enthusiasm. It was amazing to be in a room full of innovative great minds that speak from the same hymn sheet; “Palliative Care for ALL…SPICT for ALL”.
My special thanks to University of Edinburgh, Irish Hospice Foundation and Our Lady’s Hospice & Care Services.
Noela Huele is a Practice Development Nurse in Our Lady’s Hospice and Care services. She has 17 years of Clinical Nursing Experience and has dedicated 11 of those years caring for patients with palliative care needs.