The venue Oxford Town Hall is set in the historic and picturesque town centre within walking distance of the railway station.

The conference now in its 3rd year is attended by Nurses, Doctors and Allied Health Professionals, Academics and Senior Managers, Training and Development Professionals, Department Heads, Government leads and national organisations who have an interest in developing palliative care practice. 

Chair – Dee Sissons, Executive Director of Nursing, Marie Curie

Choice and the provision of End of Life Care for older adults

Over 70% of people who die in England are now aged 75 years and older at death. The needs for this older, mentally and physically frail population are very different to the population of cancer patients which have been traditionally supported by Specialist Palliative Care

• Very few people aged 75 years and over die in a hospice yet 22% die in a care home. Hospital and own home are also frequent places of end of life care and death. Many older adults have multiple emergency admissions to hospital in their last year of life, which could be avoidable with better end of life care planning
• The trajectory for end of life is very different to cancer with many older adults experiencing what has been termed 'slow dwindling'. The high prevalence of dementia - up to two thirds of those who die in care homes presents challenges in terms of choice and mental capacity to be involved in decision making in end of life care
• The role of Advance Care Planning, Electronic Patient Palliative Care Record Systems, and Legal Power of Attorney Professor

Julia Verne, Head of Clinical Epidemiology, Lead for Liver Disease Clinical Lead - National End of Life Care Intelligence Network, Public Health England

Building on the Best

Leeds were selected as one of 13 acute Trusts across the UK to take part in the national ‘Building on the Best’ programme to improve palliative and end of life care. The project was supported by the National Council for Palliative Care, Macmillan Cancer Support, NHS England, and NHS Improving Quality

• Establishment of work streams, one focusing on symptom management and the care of dying patients experiencing terminal agitation the other focusing on improving accessibility to palliative care services in the outpatient setting and empowering patients to discuss advance care planning
• Interventions tested such as education sessions, role modelling, joint multi disciplinary team working and raising awareness of resources
• Demonstrating how the interventions have made real and sustainable improvements

Chris Stothard, Nurse Specialist End of Life Care and Claire Iwaniszak, Nurse Specialist End of Life Care, The Leeds Teaching Hospitals NHS Trust

Oral care management for the patient with dysphagia

• The role of the care home team in managing palliative mouth care
• Outlining Best Practice and Quality Standards for 'Oral Care in care homes'
• Oral care management for the dysphagia patient
• Discussing mouth swabs: A safe option?

Jane Peterson, Dental hygienist and dental health educator and Sarah Barber, Dental Hygiene therapist and senior tutor, University of Portsmouth Dental Academy

Service transformation to empower urgent care clinicians to identify people who may benefit from a palliative / supportive approach to their care to improve access to appropriate care and reduce the risk of future avoidable hospitalisation

• Aim of this service transformation to offer a solution to the Sustainability and Transformation Plans aspiration to reduce avoidable admissions to hospital by 30%, while also improving access to person centred care planning
• Older people are the most frequent users of services and when admitted to hospitals are at greater risk of complications leading to longer lengths of stay and readmission rates
• Barriers to accessing palliative / supportive care is identification
• Advanced care planning is an enabler in improving person centred care and avoiding unnecessary admissions to hospital

Kerry Bareham, Matron for Palliative and End of Life Care St Barnabas Hospice in Partnership with United Lincolnshire Hospitals NHS Trust

Supportive and palliative care in care homes: Reflecting on results from the Occupational Therapy for stroke survivors living in Care Homes (OTCH) study

• OTCH the largest study to be conducted in care homes to date funded by National Institute for Health Research’s Health Technology Assessment programme
• Trial had neutral results; however, the study exposed the urgent need for increased provision of supportive and palliative care in a care home setting
• Majority of participants (>70%) were graded as severe or very severe on the Barthel Index of Activities of Daily Living. Over 70% of participants were cognitively impaired
• Over half of the participants (n=520) across both arms of the trial had a poor outcome at 3 months
• Providing and targeting, ameliorative care in a clinically complex population of care home stroke survivors in the period approaching the end-of-life requires alternative strategies

Dr. Guy Peryer, Lecturer in Health Sciences, University of East Anglia an author on the OCTH study

There is a Process to Dying: We need to understand it

• The mental states of the dying have been neglected because they were considered unimportant. Now that has changed, but the true significance of the spiritual experiences of the dying has yet to reach a wider audience
• Our research found that over 48% entered into a spiritual domain with specific characteristics in the days before death. Other more recent studies have increased this figure to over 90%
• The dying draw support from their spiritual experiences independent of their religion or spiritual belief
• Knowing how to give up and submit to the dying process leads to a more peaceful death

Dr Peter Fenwick, FRCPsych, Consultant Neuropsychiatrist, Author of the Art of Dying. Emeritus Kings College Hospital and Institute of Psychiatry

“Living” … life as a young person whilst dying … Exploring a teenage and young adult service model of care

Young people should be given the opportunity to “live whilst dying”. It is fundamental to their overall wellbeing that they are able to continue their development and feel fulfilled emotionally, physically and sexually for as long as is possible

• Multi-disciplinary approach is essential both medically and pyscho socially; a specialist team is paramount and enables professionals to instantly address young people’s bespoke needs
• As professionals we owe it to them to support and maximise their personal development during adolescent years, despite treatment or prognosis
• Building healthy relationships, promoting normality and providing advice and support in an age appropriate and positive way
• Benefits of a bespoke individualised care package for teenage and young adult couples

Shona Tutin, Teenage and Young Adult Nurse Specialist and Caroline Wiltshire, Youth Support Coordinator, Sheffield Teaching Hospitals NHS Foundation Trust

Care homes - From isolation to empowerment

• Hospital admissions from local care homes were high and low numbers of residents with advance care plans
• Hospice in your care Home team launched as a pilot project working with 8 nursing homes, with the aim of supporting and advising staff via diverse educational interventions, in a bid to enhance end of life care for residents and those important to them, whilst 'skilling up' all levels of staff to increase confidence and clinical skills
• Urgent referral system to offer dedicated support and working alongside staff when a resident has been identified as being in the last days of life
• 25% reduction in hospital admissions achieved by end of year one, number of Advance Care Plans increased from 13 to 50 across the 8 pilot homes
• Service has been chosen by Hospice UK as an innovative model which is being researched in a bid to identify if it can be replicated across the UK in other hospices

Debbie Dempsey, Hospice in your Care Home Manager and Monica McCahery, Senior Educator, Hospice in your Care Home, Wigan and Leigh Hospice

The role of the Consultant Radiographer and rapid access to palliative radiotherapy for pain and symptom control in palliative cancer patients

• Development of the role of a Consultant Radiographer to enable cancer patients requiring palliative radiotherapy rapid access to treatment
• Assessment of patients’ suitability for radiotherapy, consent for treatment, referral for radiation, plans and prescribing radiation treatment and telephone follow up during the acute treatment reaction phase
• Patient outcomes from a database of all patients attending for palliative radiotherapy
• This treatment modality being used more and more for effective pain and symptom control

Linda Bedford, Macmillan Consultant Radiographer, Beacon Centre, Radiotherapy Department, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust

Supporting informal carers - what can we do and what do we need to do?

• Caring carries significant burden and recognising that carers also need to be cared for is vital as they often suffer ill health whilst actively caring and on into their bereavement
• Carers may be the people who facilitate care being delivered in the patients’ preferred place and a well supported carer may be the one that makes that difference
• Multiple challenges and need for support and preparation including emotional, physical but also practical issues like financial
• Interventions may help carers maintain their role as carer but also help them physically, psychologically, spiritually, socially, emotionally and financially

Michelle Brown, Head of Pre-qualifying Healthcare, Adult Nursing, University of Derby