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Palliative careJan 30, 2023

Physiotherapists are 'key' to delivering specialist palliative and end of life care, says network

The Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) has welcomed the publication of guidance on delivering palliative and end of life care to adults in England.

After the document, titled Specialist palliative and end of life care: Adult service specifications, was published by NHS England on 26 January, the ACPOPC tweeted: ‘Good to see inclusion of therapy and AHP [allied health professional] roles as key to delivery of care.’

Physiotherapists are specifically mentioned in a section on the staffing levels required in specialist level palliative care (SLPC) services. These services are required for people of all ages living with more complex and/or long-term conditions that are life-limiting or life-threatening.

‘The focus of SLPC is quality of life for people with progressive life-limiting illness and meeting unresolved needs that cannot be met by their core care team. These needs may be physical, psychological, social and/or religious or spiritual,' the document notes.

Examples include complex symptoms, rehabilitation or family situations and ethical dilemmas regarding treatment and other decisions.

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NHS England recognises that physiotherapy plays a 'key' role in specialist MDTs

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As well as ensuring that consultants in palliative medicine – who may provide clinical leadership across a number of locality teams – and nurses specialising in palliative care are included in multidisciplinary teams (MDTs), physiotherapists and other practitioners with specialist skills and experience should also be available, the document states.

The MDT [should] educate and train the wider workforce delivering core palliative care [and] support and contribute to education and training at pre- and post-qualifying levels, especially in medicine, nursing and AHPs

Occupational therapists, social workers, dietitians, speech and language therapists, specialists in interventional pain management and others are mentioned alongside physiotherapists in this list of groups that will feature in MDTs.

Admin support required

Team members must be given adequate administrative and secretarial support, so that they work efficiently and effectively, and to ensure that data can be collected for service monitoring, audit and quality purposes, the document states.

They also need to offer training to the colleagues outside the core team, the report suggests: ‘As specialists, the MDT have obligations not only to educate and train the wider workforce delivering core palliative care, but also to support and contribute to education and training at pre- and post-qualifying levels, especially in medicine, nursing and AHPs.

‘The time and resources needed to carry out these obligations fully should be considered in discussions about commissioning services and education and training.'

Care of the team: 'emotionally challenging'

The document stresses that staff working in this field will inevitably face emotional challenges and that providers must ensure that every team member receives support and has opportunities to gain feedback and discuss what is happening.

‘Professionals as well as volunteers should have access to ongoing support and supervision, mental health wellbeing advice and debriefing sessions with their line manager.’

To download a copy of the NHS England document, visit: https://www.england.nhs.uk/wp-content/uploads/2023/01/B1674-specialist-palliative-and-end-of-life-care-services-adult-service-specification.pdf

To find out more about the ACPOPC, visit: https://acpopc.csp.org.uk

Author: Ian A McMillan
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