Living well with lung disease: the impact of a hospice-led multidisciplinary respiratory clinic

ABSTRACT

BackgroundLung diseases account for more than 700,000 hospital admissions, and leads to 115,000 deaths in the UK each year (British Lung Foundation. Lung disease in the UK. [Internet]. [cited 31 May 2022];Public Health England. Respiratory disease applying All Our Health. [Internet]. 2019 [cited 31 May 2022]). To enhance existing services, Dorothy House Hospice Care piloted a specialist clinic, with embedded peer support, for people with progressive lung disease.AimA key aim of this pilot project was to provide better, more personalised support to patients and thereby to support their physical and emotional well-being.MethodA fortnightly multidisciplinary clinic, delivered by a Nurse Specialist, Physiotherapist and Occupational Therapist, was piloted for 12 months from November 2020. Referrals were accepted in consultation with patients’ GPs and secondary care clinical teams. The Support Needs Approach for Patients (SNAP) tool informed the development of personalised care plans;group sessions provided information and guidance around self-management. Referrals to other Dorothy House services were also made, where appropriate. Originally intended to be face-to-face, clinics were delivered virtually (via Zoom) between November 2020 and July 2021 due to COVID-19. Patient outcomes were measured using SNAP and qualitative interviews.ResultsThirty-two patients attended the clinic. SNAP scores for wellbeing improved by between 33% and 100% (average 70%). Themes generated by the qualitative interviews (n=3) included the value of having time to talk, and reassurance from having a place to contact for advice, help and support. Patients reported physical improvements in symptoms and in emotional wellbeing. Furthermore, the clinic team reported improved communication between the hospice and patients’ local secondary and primary care clinicians. Some patients opted not to participate in a programme delivered online, thereby limiting the overall numbers attending.ConclusionFollowing the success of this pilot programme, Dorothy House has implemented a long-term conditions clinic, extending similar care to a wider cohort of patients with non-cancer diagnoses. Virtual attendance is still offered, but face-to-face is encouraged to optimise peer support.