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Public Members Meeting – Portsmouth
Thursday 23 May
6:00pm – 8:00pm
Lecture Theatre, Education Centre, E Level, QA Hospital
Present:Syd Rapson
Sarah Edmonds
Peter Mellor
Michelle Marriner (notes)
19 x Members of the Public
Syd Rapson chaired the meeting and commenced with a short introduction of the role of the Governors within the Trust.
Consultant Dr Ian Cairns and Nurse Specialist Cherilyn MacNee were in attendance and gave a presentation about the care and support provided to those who are approaching the end of their life at Queen Alexandra Hospital.
Questions from members of the public about the subject matter
Does all pain relief include sedation?
Absolutely not, pain relief is not about sedating a patient. If something causes pain during life then it will almost certainly cause paint when dying. The patient’s needs would regularly be reviewed in particular whether they would be able to swallow pain relief medication or not. There are many patients who do not require any pain relief but they would still go on the LCP as a framework for their care.
Are the family involved at any time during the process?
Yes, patients should be involved throughout treatment. The principal of communicating with the family is crucial.
Does the Trust work with other services such as Social Care within a multi-disciplinary team to provide a holistic approach for the patient?
There is currently a gap in what we are able to offer in terms of multi-disciplinary working but there is a very dedicated specialist nursing team who work with patients, their families and other organisations where possible.
Patient should plan for their own future earlier on their life so that their wishes and needs are heard.
Advanced care planning is very important. Unfortunately, we live in a culture that doesn’t like to talk about death and therefore do not think about our wishes. It is vital that any wishes are communicated to family members and the GP. There is a local register which records all of these wishes so that all organisations are aware of them. The media have portrayed this register very negatively which has prevented people from making their wishes known.
Unfortunately good news stories does not typically sell newspapers, therefore the media prefer to write stories which attract readers. If society as a whole were to take a more balanced view, it would be much easier.
At what point during treatment do you ask patients what their wishes are. Are patients aware of the services available earlier enough to be able to make a decision themselves. What happens if the family goes against the patient’s wishes once the patient is not in a position to intervene?
If a very difficult challenge for the Trust staff to manage but there is an initiative within the Trust where all patients wishes are recorded. We live in a culture where as many times; the family does not pull together for the sake of the patient.
Can the Trust work with local media to portray the LCP in a much more positive light to make the public understand it more clearly.
Agreed but it is very difficult to publicise good stories and there is always an unbalance in the media.
Is end of life care available throughout the Trust or just in particular wards?
The care is available throughout the Trust. Ward G5 closed as it was felt unfair for all patients needing care who could not get into G5. The Trust now offers the same high quality service throughout the hospital.
There are many staff across the organisation who are involved in patient care who are not Doctors or Nurses. How do these teams communicate to ensure best care for the patient?
There are various communication mechanisms throughout the Trust.
General questions about the Trust
There is an overburdening pressure on some services such as MacMillan. There is a concern that if that pressure continues, it would have an impact on the quality of care provided.
There is a need for a balance. We are within a financially restrained organisation required to make huge savings yet cannot compromise patient safety. There is a real mismatch between an ever increasing demand vs a decreasing budget.