Management of common symptoms for people approaching the end of their life can be challenging.
What are we doing to support professionals?
In order to ensure that they have the right guidance to support their patients a Palliative Care Clinical Practice Summary has been developed covering the main problems that people might encounter. This supports decision-making in symptom management and care coordination for people in the last weeks of their life. If there is any doubt regarding clinical decisions for individuals, help should be sought from local Specialist Palliative Care services.
In 2012 Lancashire and South Cumbria Specialist Palliative Care group wrote prescribing guidelines around managing common symptoms in a palliative care setting. These were well received and in 2014 were updated. In 2016, Lancashire & South Cumbria (LSC) joined with Cheshire & Merseyside (C&M) as a new North West Coast (NWC) Strategic Clinical Network. The first edition 2017 version for LSC was developed, based on the guidance produced by our neighbouring Northern Strategic Clinical Network’s Guidelines (2016) and C&M Clinical Practice Summary (2017).
These guidelines were formally reviewed and approved in Lancs and South Cumbria in 2021 and subsequently adopted and approved through the medicines management process in Cheshire and Merseyside in 2022 and is now the North West Coast guidance covering both LSC and C&M.
The summary includes guidance on managing symptoms in bowel obstruction, breathlessness, constipation, nausea & vomiting, pain, palliative care emergencies, respiratory tract secretions, agitation, continuous subcutaneous infusions and renal failure.
This is not mandated guidance and there is no expectation that localities should adopt it if they have local guidance that works for them.
The updates to the 2nd Edition North West Coast Palliative Care Clinical Practice Summary have been reviewed in the following educational resource. This PowerPoint video presentation has been uploaded in 6 parts and may be used to support education sessions delivered by localities across the North West Coast network areas.
- Introduction to LSC Clinical Practice Summary (part 1)
- LSC Clinical Practice Summary Presentation (part 2): Pain and Agitation
- LSC Clinical Practice Summary Presentation (part 3): Breathlessness, Nausea & Vomiting and Secretions
- LSC Clinical Practice Summary Presentation (part 4): Diabetes Management
- LSC Clinical Practice Summary Presentation (part 5): Haemostatics
- LSC Clinical Practice Summary Presentation (part 6): Opioid Conversion