Waight Catherine, Noble Bill
Cornwall Hospice Care, St Austell, UK.
Public Health Palliative Care International.
Future Healthc J. 2018 Feb;5(1):7-9. doi: 10.7861/futurehosp.5-1-7.
Ensuring high quality of care for dying patients and their families is a challenge for both primary and specialist palliative care services throughout the UK. A model of a consultant-led palliative care community team was set up following the closure of a specialist palliative care inpatient unit in Midhurst, with the aim of providing that same level of care to patients in their own homes, care homes and community hospitals. It works closely with primary care to enhance community services and with secondary care to enable rapid discharge from hospital to the community. Anticipatory prescribing, advanced care planning and education of social care and nursing home staff are also key aspects of the service. The Macmillan Midhurst Service costs an average of less than £3,000 per patient and enables 85% of referred patients to die in their preferred place. Evaluations of the service have highlighted benefits to patients and families as well as cost reductions to the NHS of around 20% when patients are referred early.
确保为临终患者及其家人提供高质量护理，对英国各地的基层和专科姑息治疗服务来说都是一项挑战。在米德赫斯特的一家专科姑息治疗住院单元关闭后，建立了一个由顾问主导的姑息治疗社区团队模式，目的是为在家中、养老院和社区医院的患者提供同样水平的护理。该团队与基层医疗紧密合作以加强社区服务，并与二级医疗合作以使患者能从医院快速出院回到社区。预期性处方、预先护理计划以及对社会护理和养老院工作人员的教育也是该服务的关键方面。麦克米伦米德赫斯特服务平均每位患者花费不到3000英镑，能使85%被转诊患者在他们希望的地方离世。对该服务的评估突出了对患者及其家人的益处，以及当患者被早期转诊时为国民保健制度节省约20%的成本。
