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Implementing the new priorities of Care of the Dying Person

Dr Susan Salt Medical Director Trinity Hospice spoke at today’s Delivering Individual Care Plans for Care of the Dying Person on:

• the new priorities for care of the dying person
• implementing the priorities
• outcomes and guiding principles
• phasing out the LCP: see the person not the paperwork
• education, training and professional development
• monitoring the implementation of priority 5

Susan discussed the individualised end of life care plan priorities highlighting the importance of good communication, documentation, delivering information and involving the appropriate people.  Susan looked at the challenges and how to overcome them such as how death and dying is a difficult subject but she encourages students to be brave and honest and use the words 'death' and 'dying'.  Susan talked about improving how you document emotive conversation in the clinical record, saying it can be really difficult to do whilst considering patient confidentiality.  She also said we need to think more about how patient information is delivered so that it is personalised and appropriate to the individual patient.  

Susan talked about a model they use in the North West that provides guidance for different stages of end of life care to help individualise care.

Susan finished by saying end of life care needs to be looked at as a partnership; two lots of people both with unique skills and experience.  She said we need to be generous with time, offering compassion and walking alongside 'doing' together to make a difference. 

Abstract of Dr Salt’s talk
Being part of any team providing care to an individual at the end of life is both challenging and a privilege.

There is only one chance to get it right.  When done, the experience lives on in those close to that individual and enables the continuation of a therapeutic and trusting relationship with healthcare.  If not done well there is a significant risk of adverse health consequences for those involved and damage to the relationship between individuals and their own healthcare providers.

Done well can be a source of tremendous professional satisfaction involving all the core skills of any clinician:
•    Excellent diagnostic skills
•    Excellent communication skills
•    Clinical acumen
•    Knowledge of pharmacology and symptom management

There are a number of challenges that make caring for people at end of life 
•    Managing diagnostic uncertainty
•    Paucity of robust evidence on which to base clinical decisions
•    Ethical dilemmas around risks and benefit of actions
•    Managing the emotion of an irreversible and final event which ultimately remains inexplicable
•    The sense of being unable to influence an inevitable and overwhelming event that we would prefer to avoid and in some cases deny

End of life care is everyone’s responsibility.
It is deceptively simple based on excellence in the provision of basic care

Dr Salt’s full presentation is available for download at the end of this page

Dr Susan Salt
Born in Sale, South Manchester
Trained as a doctor at St Mary’s’ Hospital Medical School – where the Horizon film Doctors to be was filmed (20 year up date just been on television)
Junior doctors post in and around South Manchester in medicine, paediatrics and obstetrics and gynaecology.
Trained as a GP in Rochdale.
Had to cover the local hospice when on call.  Realised I new very little about palliative care.  Got a post in a temporary post hospice to enhance my skills and liked it so much I retrained as a specialist.  

Trained as a specialist in Palliative Medicine in Leeds and Bradford

Appointed a consultant in Palliative Medicine in Calderdale, West Yorkshire.

Husband, as Anglican clergyman was appointed to Thornton parish Church.  I had to move or divorce him so I moved.

Appointed to Trinity in January 2007.  Became medical director in April 2008

Chair of the Palliative and End of life care Advisory Group for Lancashire and South Cumbria

Future events of interest
 

Legal Issues in End of Life Care Masterclass
Tuesday 10 March 2015 
Hallam Conference Centre, London

Legal Issues in End of Life Care Masterclass
Tuesday 19 May 2015 
Hallam Conference Centre, London

Improving End of Life Care
Wednesday 20 May 2015 
Colmore Gate Conference Centre, Birmingham


Download: Susan Salt full presentation

21 January 2015

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