As I approached the venue last Wednesday, I was full of optimism for what was in store: a varied and comprehensive programme of plenaries and sessions, and the opportunity to network with colleagues from a variety of disciplines and settings; I wasn’t disappointed.
Once the Help the Hospices exhibition stand was set up, I headed off to the main auditorium for the first session of the Congress – ‘Delivering effective home-based palliative and end of life care via strong partnerships’.
First up, we heard from Help the Hospices Clinical Director Heather Richardson on the work of the Commission into the Future of Hospice Care. Reflecting on the challenges facing end of life care services, she highlighted the need for creativity and collaboration in planning and delivering care, and called on people to show courage and strong leadership.
We then heard about the Midhurst Macmillan Specialist Palliative Care Service – a model of early referral, clinical interventions at home and proactive collaboration with primary care, which in 2012/2013 enabled 81% of all patients remain in their preferred place of care (91% for patients whose preferred place was known). The important role of volunteers was flagged as we learnt about the service’s rapid response volunteers, and we also heard how the model gives people dignity and respect and a feeling of safety.
The session ended with a look at six new Innovation Centres set up to replicate elements of the Midhurst Service and develop new workforce solutions. Details of this initiative have already been published on ehospice.
As well as the need for collaboration and innovative thinking, a key theme emerging from this session was the need to build the evidence base for hospice and palliative care, which is a top priority for Help the Hospices.
Official opening and opening plenary
The official opening of the Congress came on Thursday morning with an address from Dr Bill Noble, Medical Director at Marie Curie. After welcoming everyone and highlighting the importance of the Palliative and End of Life Care Priority Setting Partnership, he handed over to Dr Florian Strasser, Associate Professor of Oncological Palliative Medicine, St Gallen, Switzerland, who spoke about cachexia in the palliative care context.
Dr Strasser stressed that palliative care interventions are relevant in care of cancer cachexia patients and their families, reflecting that cachexia is an excellent example of early integration of palliative care interventions into mainstream advanced medical care.
There were several concurrent sessions throughout the Congress, giving delegates the opportunity to learn about the wealth of research and innovative projects happening in the sector.
Two of the sessions I plumped for included the role of nurses in palliative care, and the education of non specialist palliative care. I heard about a new dignity intervention tool for nurses which could feasibly be used to conserve dignity in dying patients, as well as research which showed that while the majority of paramedics feel end of life care is a key part of their role, they often feel left out of the conversation about it. I also learnt about the dedicated palliative care ambulance service in Leeds which is helping ensure patients are cared for in their preferred setting, and discovered there is a need for more end of life care education and training for frontline emergency staff.
The hot topic
While the concurrent sessions were an excellent opportunity to learn from others, it was the two sessions on the Neuberger report into the Liverpool Care Pathway which really captured my attention, and which led to a really interesting discussion and debate among the invited speakers and delegates.
On the panel of the first of the two sessions – which were billed as an opportunity for discussion about the future of end of life care in the health service following the Neuberger report – were Rob George, Professor in Palliative Medicine at Guy’s and St Thomas’, and Dr Gerard Corcoran, Consultant in Palliative Medicine at the Marie Curie Palliative Care Institute Liverpool. Opening, Professor George said there was a systemic problem with how dying people are looked after in hospital, while Dr Corcoran stressed the importance of reinforcing the ethics of palliative care.
After they had both introduced the topic, the discussion was opened up to the floor, which led to a rush of hands as seemingly everyone had an opinion or comment to make.
One delegate emphasised that death is everybody’s business, stating that we need to support healthcare professionals who struggle with it. Another went as far as to say that it was embarrassing if doctors didn’t educate themselves about caring for the dying – calling it an issue of personal pride. Meanwhile a visitor from overseas informed everyone that the LCP is alive and well in New Zealand.
The second session focused on what comes after the Neuberger report, with Dr Corcoran this time joined by Dr David Brooks, President of the APM, who said that the problem is often that the focus is on the process instead of the patient, and that dying should be a core part of doctors’ and nurses’ practice.
Again, there was no shortage of people wanting to share their views on how to deal with the fall out of the LCP scandal. “We need to be proactive in explaining what we do at the end of life – we can’t be passive about this,” was one comment, while another delegate said that palliative medicine specialists need to lead on collecting evidence about patient experience. But seeing the phasing out of the LCP as “a good opportunity to start again and reflect on what we want to achieve”, was the one comment which really stuck with me as I headed out of the auditorium to be met by the sounds of the brass band playing below.
During the three days I spent at the Congress, I witnessed the dedication and expertise of the people working in the hospice and palliative care sector. The innovative projects on show were truly inspiring, with one in particular catching my eye – a project by archaeologist Dr Karina Croucher on using stories from the past to facilitate discussions around death (look out for an article about this on ehospice next week).
It was also great to see so many people using social media to share the wealth of knowledge and good practice with colleagues, and you can follow the conversation that occurred on Twitter throughout the event using the #PCC2014 hash tag.