UK – Scotland
Lead SPICT Partner: Dr Kirsty Boyd
We are implementing the national palliative and end of life action plan throughout NHS Grampian and SPICT is a key element within the programme to help to identify patients in:
- Primary care
- Community hospitals
- Care homes
- Acute hospitals
Contact: Dr Sally Lawton
NHS Forth Valley (Forth Valley Royal Hospital)
Clinical Lead – Dr Dan Beckett (Lead Acute Physician)
Using SPICT encourages a ‘thinking ahead’ approach to care and avoids acute episodes of care being looked at in isolation.
SPICT multidisciplinary working group – Jennifer Wilson (Lung Cancer CNS), Evelyn Paterson & Mairi Armstrong (Palliative Care CNSs), Dr Stan Wright (Respiratory Physician), Elizabeth Ramage (Respiratory Ward Charge Nurse), Olwyn Lamont (Respiratory CNS), Paul Baughan (Lead Cancer GP), Dr Gill Foster (Hospice Associate Specialist)
SPICT is being introduced into the Acute Medical Unit (AMU) and the general medical wards in Forth Valley Royal Hospital ( a large district general hospital in central Scotland) as part of an ongoing project to improve recognition and responses to the ‘deteriorating patient’.
Early anticipation, collaborative care planning and decision-making are the primary drivers for this project. In AMU, when a patient is identified as deteriorating on the National Early Warning Score (NEWS) alert system, SPICT is used as part of the assessment process. The goal is to help staff use a structured response to physiological deterioration. The outcome of the assessment might include appropriate anticipatory care planning for people with life limiting conditions where escalation of care may not be appropriate. Using the SPICT helps staff identify unmet palliative/supportive care needs.
In the general medical wards, all admissions will be screened with SPICT. Using SPICT encourages a ‘thinking ahead’ approach to care and avoids acute episodes of care being looked at in isolation. Staff are encouraged to recognise the uncertain but predictable patterns that emerge with advanced long term illnesses and other life limiting conditions and provide appropriate care, based on a changing health picture. This will influence decision making and care in a positive way and present previously missed opportunities to have important discussions that will influence decision making and future care.
SPICT will form part of core documentation for all patients (on the reverse of the NEWS chart). Alongside education on the use of NEWS chart and reliable response stickers, staff will also receive education in key aspects of advance and anticipatory care planning (ACP or AnCP). All ward staff are encouraged to recognise the important role they play in this process and the need to ensure any care planning discussion is documented and communicated to Primary Care Teams at discharge.
SPICT is also being used to promote awareness of electronic Key Information Summaries (KIS). The eKIS is an online care plan completed by practice staff in Primary Care that can be viewed during unscheduled/ emergency care episodes. The information provided to GPs on discharge from hospital can about a patient’s anticipatory care plan in the event of further deterioration can then be added to the eKIS.
It is hoped that SPICT will link with Scotland-wide initiatives such as; DNACPR (Do not attempt CPR), anticipatory care planning and electronic patient care plans/ records such as KIS to promote high quality, coordinated supportive & palliative care.
We’re the UK’s leading charity caring for people living with any terminal illness, and their families. We offer expert care through our home nursing and hospice services, as well as information and support for patients, their loved ones and the professionals who care for them.
Uses of SPICT
SPICT is used by Marie Curie nurses working in the community.
It also appears on the Palliative Care Knowledge as a link for healthcare professionals
The Marie Curie Palliative Care Knowledge Zone is an easily accessible, free of charge resource for non specialist healthcare professionals. It provides information regarding caring for people and their families at end of life along with links to partnership organisations.
Contact: Tracey Buckley