Why use SPICT™?
SPICT™ is a clinical tool used by health and care professionals around the world. SPICT™ helps identify people with general indicators of poor or deteriorating health, and one or more advanced, conditions or a new serious illness. SPICT™ looks for changes in health status, and increasing care and support needs.
Many people (particularly with organ failure, frailty or multimorbidity) can benefit from well-coordinated care planning and earlier palliative care integrated with the best available treatment of underlying illnesses.
Ways to use SPICT™
- SPICT™ has 6 general indicators of deteriorating health and increasing care needs, including trigger events (e.g. hospital or care home admission).
Use them to prompt an assessment and/or SPICT indicators of advanced conditions.
- SPICT™ also outlines six core aspects of palliative care and future care planning.
- The RED-MAP framework (see below) is used to guide conversations about care planning.
Other tools used with SPICT™
- Functional decline
(e.g. Australia-modified Karnofsky Performance Scale) [Reference].
- Stage of illness
(e.g. Palliative Care Phase Tool) [Palliative Care Outcomes Collaboration]
- Patient-reported outcome measures of multidimensional needs
- Frailty tools for older people
(e.g. Clinical Frailty Scale, Electronic Frailty Index)
Where access to palliative care depends on estimated life expectancy, cohort research based on 2 or more SPICT™ general indicators gives a population risk of dying within 12 months. However, prognosis for an individual remains variable and uncertain. (Publications)
A 6-step guide to future care planning conversations with people whose health is deteriorating, and their families.
RED-MAP helps us prepare, share information, find out what is important, and agree goals and actions for a future health and care plan.
RED-MAP: Care Planning with ReSPECT (pdf)
Developed for the NHS Scotland ReSPECT digital app – March 2021.)
Key steps in future care planning
Preparation & planning
(Identify who needs care planning – prepare as professionals, and the people involved)
(Use RED-MAP. Find out ‘what matters’ and ‘who matters’ to the person.)
Documentation & sharing
(Record and share care plans so everyone knows the right thing to do.)
(Care plans are updated as the person’s situation or preferences change.)
Used with permission from Healthcare Improvement Scotland, Improvement Hub
Benefits of using SPICT™
- Offers people opportunities to talk about their health declining and ‘what matters’ to them including things they hope to do, would like to happen, or wish to avoid.
- Gives priority to maintaining a person’s quality of life, and involving the people who are close to them.
- Ensures that any available disease-modifying treatments of benefit are combined with good symptom control and other aspects of palliative care.
- Reduces the risk of complex treatment and care decisions in a ‘crisis’ by making emergency care plans for acute illness or complications (including for family caregiver changes).
- Encourages people to appoint a proxy decision-maker (Power of Attorney) and/or make ‘advance decisions’ about any treatments they do not want in the future.
- Improves communication, continuity of care, current and future care planning; and multi-disciplinary team work.
- Includes family members and other carers so they receive the help and support they need.