#sppc2014
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Password: chiron1681

http://www.palliativecareguidelines.scot.nhs.uk/

http://www.testing29.scot.nhs.uk/

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Evidence-based clinical guidelines supports the provision of high quality palliative care by both specialists and general staff.

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NHS QIS to work with Boards and SPPC to agree a national guideline for each core topic and a robust mechanism for reviewing and updating.
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All Health Boards to ensure that guidance on all core topics is made available

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National Palliative Care Guideline project started
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Supported by Scottish Partnership Palliative Care
(SPPC) and Healthcare Improvement Scotland (HIS)
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Co-chairs:
Dr Paul Baughan, GP, Dollar and clinical lead NHS FV
Dr David Gray, Consultant in Palliative Medicine Accord
Hospice, Paisley
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Aim to include a mix of professionals including pharmacy, primary care and public representation

The Guideline Project Steering Group:

The Guideline Project Steering Group:

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HIS agreed to provide methodological advice
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NES agreed to provide librarian support

June – August 2012 – 628 responses:
highlighted many things liked in existing guidelines
- some areas that would like to see developed
- suggestions about formatting / accessibility

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Pain Assessment
Pain Management
Neuropathic Pain Management
Choosing and Changing Opioids

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Anorexia/Cachexia
Bowel Obstruction
Constipation
Diarrhoea
Hiccups
Nausea and Vomiting
Oral Care

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Care in last few days of life
Complex discharge for end of life care
SC hydration
Emergencies – fits/ MSCC/Bleeding
OOH Handover Information
Uncontrolled severe distress
Last days of life - Renal Disease

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Delirium
Depression
Hyercalcaemia
Pruritis
Sweating
Syringe pumps

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Breathlessness
Weakness/Fatigue
Cough

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Produced with support of Scottish Palliative Care Pharmacists Association
Alfentanil
Fentanyl Patches
Fentanyl Nasal Spray (Pecfent)
Fentanyl Sublingual (Abstral)
Fentanyl Buccal (Effentora)
Ketamine
Levomepromazine
Lidocaine
Methadone
Methylnaltrexone
Midazolam
Naloxone
Octreotide
Oxycodone
Phenobarbital (Phenobarbitone)

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Internal review of initial guidelines
Each subgroup reviewed other subgroups’ work
Steering group meetings held at GMC

Outcome of Internal Review of Guidelines

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Supported by Scottish Health Council /
SIGN User Involvement Officer
Meeting in Edinburgh with carers and members of public
Helped to ensure focus and balance was right

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Co-ordinated independently by Dr Paul Keeley
Experts identified from around UK
Comments to subgroups
Each comment logged and considered
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Final drafts to Medical Writers for readability

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Paper presented to national Directors of
Pharmacy
Letter sent to each health board ADTC recommending adoption of guidelines
Some Health Boards have already approved, others still to discuss

http://www.testing29.scot.nhs.uk/

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HIS will take ownership of the guidelines
SHOW will host
App

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HIS is developing a light touch process to ensure the currency of the guidelines in the future
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Patient Information update – a separate project with dedicated funding and resources?
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Electronic teaching modules for medical staff
Fiona Downs

http://www.testing29.scot.nhs.uk/guidelines/ab out-the-guidelines/contributors.aspx

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Familiarise yourself with the guidelines
Discuss them with colleagues
Refer to them for clinical advice or when teaching
Ask your health board / MCN how they are promoting them

#sppc2014
RCPE-WIFI
Password: chiron1681