Explaining Specialist Palliative Care
Some people, who have more specialised or complex needs, may require care from specialist health and social care staff who have specialist training and expertise in palliative care. This care may be directly provided for the person and those important to them or through the provision of information and guidance to the other staff already caring for the person.
Why a person may require Specialist Palliative Care?
Specialist Palliative Care staff work together usually as part of a multidisciplinary Specialist Palliative Care Team. They provide:
- Advice on the management of symptoms such as pain, breathlessness or sickness
- Support to the person and those important to them in order to help them manage their illness
- Information about social, practical and financial issues
- The opportunity for the person and those important to them to discuss concerns or questions about their illness and treatment plan as well as on making plans for the future when appropriate
- Advice on other support services
- Help to facilitate where the person wants to be cared for. This may be at home, in hospital, a hospice or in a care home where possible and appropriate.
When is Specialist Palliative Care required?
Add here about ant any stage of the illness and that may be discharged from case load and come back onto caseload as need arises. Often people with palliative conditions can be cared for by their GP, District Nurse, Ward Team and/or a relevant Specialist Team/service (e.g. Heart Failure Service)
Who provides Specialist Palliative Care?
Palliative Care Nurse Specialist
Palliative Care Clinical Nurse Specialists are nurses with advanced qualifications and knowledge in symptom management and palliative care. They are based within hospitals as well as in the community. They provide information and advice to multidisciplinary Teams that are caring for palliative patients and those important to them. By linking in closely with other Teams in hospital and community they help to ensure the appropriate services and support networks are in the patient’s place of care.
Palliative Medicine Consultant
Palliative Medicine Consultants are doctors with specific training in palliative care. The Palliative Medicine Consultants meet regularly with the other specialist palliative care staff to discuss patient care and to plan assessments and reviews of patients within the hospital and/or in the community. The Palliative Medicine Consultant also provides information, guidance and training to hospital and community staff caring for palliative patients.
Specialist Palliative Care Physiotherapist
Physiotherapists can help palliative patients manage symptoms of breathlessness and improve respiratory function. They work to maintain optimum circulatory function in the management of lymphoedema. The Physiotherapist can help the patient to manage their pain, to optimise their independence and confidence. Often they will assess the patient’s mobility and advise a suitable home exercise programme or provide a suitable aid to help with this. The Physiotherapist can also educate families and carers in the management of symptoms and how to maximize independence.
Specialist Palliative Care Occupational Therapist
Occupational therapy aims to help you with carrying out day-to-day activities/ tasks such as: getting up, washed and dressed, engaging in hobbies/interests and getting out and about. The aim of Occupational Therapy in palliative care is to: optimise and maintain function; promote dignity; promote confidence; promote safety and to facilitate participation in activities most meaningful to the person. The Occupational Therapist may teach the person new ways of completing activities, provide aids and equipment, or advise on adaptations that would help the person cope within their home environment. Occupational Therapist will provide patient-centred assessment and intervention to manage changing needs. They can teach the person ways to self-manage symptoms such as fatigue, breathlessness, anxiety and pain. Improving such symptoms may contribute to maintaining or improving the person’s functional ability.
Specialist Palliative Care Social Worker
Social Workers can assess, arrange and provide support and information to patients and families during difficult times in their lives, including serious illness. Social workers work closely with other members within the health and social care team, ensuring the person has the support and assistance they require to feel supported, safe and comfortable. The Social Worker can provide guidance and support surrounding practical issues (e.g. arranging a package of care to assist with care needs), emotional issues (e.g. dealing with the effects of the illness on the individual and on relationships with their family/friends), social issues (e.g. housing) and financial issues (e.g. access to the appropriate financial support).
Specialist Palliative Care Dietitian
It is important for patients who have palliative care needs to eat well and receive the right nutrition. The right nutrition can enhance mood and ensure that the patient has enough energy to provide the body with the right fuel and nutrients. Eating problems can be common in palliative patients and can include loss of appetite, swallowing issues, nausea, vomiting, constipation and weight loss. The Dietitian completes tailored nutritional assessments, provides information about diet, assists patients and families in making more effective choices about food, and assesses for nutritional supplements.
Specialist Palliative Care Speech and Language Therapist
The Speech and Language Therapist helps individuals, and their family/carer, to manage any difficulties that the person may be having with communication or swallowing, to ensure as much independence and ease as possible with these areas. To assist individuals with communication difficulties, the Speech and Language Therapist may provide exercises, advice surrounding alternative methods of communication, or advise on a piece of equipment which will aid communication and assist individuals in being able to communicate with family and friends.
Specialist Palliative Care Pharmacist
The overall role of the Pharmacist is to ensure the medications prescribed are done so in a safe and appropriate way for each individual patient. The Pharmacist will be involved in checking the person’s drug history, giving advice on preparing and prescribing medications, supporting ward Teams to ensure the appropriate discharge medications are prescribed and supplied and liaising with the GP and/or community pharmacist to provide medication advice. The Pharmacist provides advice and guidance to individuals, their family/carers on medications, ensuring that all questions surrounding medication are clarified. The Pharmacist will also address medication related queries from medical, nursing and other healthcare staff, and review prescriptions to ensure they are suitable for each individual patient (for example: checking for drug interactions, or ensuring liquids are used if an individual is unable to swallow tablet/capsule form).
The Chaplain is available to provide spiritual and religious care and support to all patients, their families, staff and volunteers within the healthcare setting, regardless of faith and beliefs. The Chaplain provides compassionate presence and support, with such support focusing on emotional or spiritual adjustment to illness, or to search for meaning/purpose through difficult times.
Some of the Specialist Palliative professionals within the Southern Trust have initial or ongoing funding from Macmillan Cancer Support or Southern Area Hospice Services. Such staff will have Macmillan or Hospice in their professional title to reflect the funding source for example Macmillan Palliative Care Dietitian, Macmillan Nurse Specialist or Hospice Nurse Specialist)
Where is Specialist Palliative Care provided?
Specialist Palliative Care Teams are available to provide advice and support to people in their own homes, care homes, hospitals, and hospices. This can include in-patient and outpatient facilities as well as providing bereavement support.
Hospital Specialist Palliative Care Team
Specialist Palliative Care is provided within the two acute hospitals in the Southern Trust – Craigavon Area Hospital and Daisy Hill Hospital, Newry. The Hospital Specialist Palliative Care Team provides support, information and advice to the hospital teams/services caring for palliative patients, their families and carers.
The Hospital Specialist Palliative Care Team is made up of medical consultants, specialist nurses, allied health professionals, a pharmacist and a social worker.
Patients may be referred to the Hospital Specialist Palliative Care Team at any time from diagnosis of a life-limiting illness through to end of life care. Reasons for referral may include; symptom management; psychological, spiritual and social support, complex discharge planning and end of life care.
Referrals to the Hospital Specialist Palliative Care Team can only be made if the patient has consented and the hospital consultant has agreed for the Specialist Palliative Care Team to visit the patient.
The Hospital Specialist Palliative Care Team is available in Craigavon Area Hospital and Daisy Hill Hospital Monday to Friday 9am – 5 pm.
Contact details for the Hospital Specialist Palliative Care Team:
Craigavon Area Hospital
Palliative Care Nurses:
- Palliative/Supportive Nurse Specialist – 028 375 61933 or 028 375 61931
- Palliative/Supportive Care Nurse 028 375 61930
Gynaecological Cancer Nurse:
- Macmillan Nurse Specialist – 028 375 61934
Upper Gastrointestinal Cancer Nurse:
- Macmillan Nurse Specialist – 028 375 61932
Lung Cancer Nurses:
- Macmillan Lung Cancer Nurse Specialist and Macmillan Lung Cancer Nurse – 028 375 60098
Other Specialist Palliative Care Staff at Craigavon Area Hospital
The following Specialist Palliative Care Staff below can be contacted by telephoning Craigavon Area Hospital on 028 3833 4444:
- Occupational Therapist
- Social Worker
Daisy Hill Hospital
Generic Palliative Care:
- Palliative Care Clinical Nurse Specialist – 028 375 62916
- Palliative Care Nurse – 028 375 62916
Other multi-disciplinary staff members are available in Daisy Hill Hospital and can be contacted by telephoning Daisy Hill Hospital on 028 3083 5000 or through the ward staff caring for the person.
Consultants in Palliative Medicine
The Palliative Medicine Consultants work across both Craigavon Area Hospital and Daisy Hill Hospital. They can be contacted by telephoning their secretaries:
- Consultant secretaries – 028 375 60754 or 028 375 62917
Community Multi-Disciplinary Specialist Palliative Care Team
The Community Multi-disciplinary Specialist Palliative Care Team includes Specialist Palliative Care Nurses, Palliative Medicine Consultants, Social Workers, Physiotherapists, Dietitians, a Speech and Language Therapist and an Occupational Therapist. Members of the team may visit and support people and those important to the person in their own home, in care homes, in a clinic, a non-acute setting or in hospice.
The Team provides: advice on symptoms; support to help the person manage their illness; opportunities to discuss concerns about the illness; information about social, practical and financial issues; advice on other services; help to facilitate where you want to be cared for.
The Community Multi-Disciplinary Specialist Palliative Care Team will work alongside other professionals involved in the care of the person such as the person’s GP and/or District Nurse.
The person will have been referred to the Team because they require support for specific needs. Once these needs have been addressed the person may be discharged from the Team’s care. However, if the person requires further help in the future they may be referred back to the Team by another professional involved in their care.
Contact Details for Community Specialist Palliative Care Team:
Specialist Palliative Care Nurses, Armagh & Dungannon Area
Armagh Community Hospital
1 Tower Hill
Co. Armagh, BT61 9DW
Telephone 028 375 65350
Specialist Palliative Care Nurses, Craigavon & Banbridge Area
100 Sloan St
Co Armagh. BT66 8NX
Telephone: 028 36 560592
Specialist Palliative Care Nurses, Newry & Mourne Area
Palliative Care Team Office,
12 Convent Hill,
Telephone: 028 308 30291
Specialist Physiotherapists, Social Workers, Speech & Language Therapist and Occupational Therapist
100 Sloan St
Telephone: 028 36 560592
100 Sloan St
Telephone: 028 37 565390
Palliative Medicine Consultants
Craigavon Area Hospital
68 Lurgan Road,
Contact via secretary
028 375 60754 or 028 375 62917
In-patient Specialist Palliative Care
The Southern Area Hospice Services provides in-patient specialist palliative care. It has a 14 bedded specialist palliative care in-patient unit located at St. John’s House, Newry. The overall aim of the unit is to ensure that patients are comfortable during their stay and that they receive the highest possible quality of care.
Patients may be admitted to the in-patient unit for the control of symptoms such as pain or nausea; rehabilitation following treatment; respite or for care at end of life. They can avail of treatment and advice from different members of the multidisciplinary team including: Medical, Nursing, Physiotherapy, Social Workers, Chaplaincy and Complementary Therapy staff.
People usually spend two weeks in the in-patient unit but this may be longer or shorter depending on their needs. When symptoms are controlled, the patient may return home. Patients can then avail of other Hospice services such as Out-Patients Clinics, Hospice Day Care, Donaldson Counselling and Therapy Centre or Resource Centre.
For further information about the in-patient unit contact the Southern Area Hospice Services:
Address – St. John’s House, Courtenay Hill, Newry, Co. Down.
Telephone – 028 3026 7711
Day Hospice facilities are available in Dungannon and Newry and are provided by Southern Area Hospice Services. These facilities are managed by nurses and offer support to patients with advanced illnesses such as cancer, multiple sclerosis and Motor Neurone Disease. They are available during the day for people who are living at home. As well as supporting people with advanced illnesses, they provide respite for carers.
The Day Hospice Unit in Dungannon is based on Floor D at the South Tyrone Hospital. It is open two days per week, Tuesday and Wednesday from 9.30am – 3.30pm.
The Day Hospice Unit in Newry is based at St John’s House, Newry. It is open four days per week, Monday to Thursday from 9.30am – 2.00pm
For further information about Day Hospice contact the Southern Area Hospice Services:
Telephone – 028 3026 7711
Out-patient appointments – Palliative Medicine Clinics
People living at home who require control of complex symptoms may be assessed by a Consultant in Palliative Medicine at one of the Palliative Medicine out-patient clinics.
Patients may be referred for an appointment by their GP or Hospital Consultant. Referrals can be accepted by the secretary for the Consultant in Palliative Medicine.
Out-patient clinics are available at Craigavon Area Hospital and Daisy Hill Hospital.
Consultant in Palliative Medicine secretaries:
Telephone – 028 375 60754 or 028 375 62917