Faithful support enables scanning success for unique Princess Alice Hospice course (FASP)

The use of bedside ultrasound in palliative care enables patients to be assessed by their hospice clinicians without having to be transported from the hospice to an acute hospital setting.

It also allows patients to be scanned at home to see if they would benefit from admission, at a time when patients and families are particularly vulnerable and keen to avoid unnecessary disruption.

Palliative care doctors and nurses trained in FASP are able to answer a limited number of specific questions to help in clinical decision making. Yet, even answering these limited focussed questions can provide invaluable help to clinicians seeking to make difficult decisions with patients about optimising their palliative care.

Focused Abdominal Sonography in Palliative care (FASP) has been a weekend course run regularly at least twice a year at Princess Alice since 2010.

The course has been staged through the Education and Research department at Princess Alice Hospice by Professor Max Watson, an honorary consultant at the Hospice, trained in ultrasound; Dr Bernie Lee, who has been using ultrasound in her clinical practice at the Hospice for many years and, more recently, by Ultrasonographer Jo Eastman. 

Crucially, each of the Princess Alice courses has been supported by Mr Nitin Patel and his wife Hina, from Pie Data, a supplier of Ultrasound technology. Max first met Nitin when he serviced his ultrasound machine in Northern Ireland and expressed willingness to help support the FASP programme.

For over 14 years, the Patels have transported ultrasound machines to Princess Alice Hospice and helped teach the FASP candidates in the vital practical sections of the course. Their generosity with their freely given time and expertise has enabled FASP to train over 400 doctors and nurses in practical palliative care ultrasound.

Professor Max Watson said: ‘’Nitin is an invaluable teacher on the programme, helping candidates to identify the images which are crucial in diagnostic terms. Hina has been a huge support also in FASP allowing herself to be scanned and providing that opportunity for candidates to get crucial practical experience during the programme.’’

The particular scans that FASP focuses on include bladder scans, to see if patients can avoid a catheter; scans to see if patients with swollen abdomens would benefit from having that fluid drained; the assessment of deep venous thrombosis, and the use of ultrasound to help identify the causes of jaundice.

By being so focused on these limited ultrasound assessments, experienced clinicians can acquire the skills in a weekend provided they continue to use FASP at their place of work and continue to audit their scans long-term.

There are currently no other UK ultrasound courses specifically focused on training palliative care clinicians. Princess Alice Hospice has pioneered that work and candidates evaluate the programme highly. Since its induction, FASP graduates have completed several published studies demonstrating the efficacy and benefits for patients of Ultrasound access. 

Jane Berg, Director of Skills, Knowledge and Research at Princess Alice Hospice, said: ‘’We are indebted to Nitin and Hina for their invaluable support for this programme, which has brought benefit to innumerable patients with palliative care needs across the country.’’