Occupational Therapy News OTnews April 2019 | Page 20

FEATURE PALLIATIVE CARE
Palliative care – whose
responsibility is it to deliver?
Jeni Woods and Lara
Cowpe share the findings of
the RCOTSS-OPC project
to explore the experiences
of occupational therapists
delivering palliative care
20 OTnews April 2019
hospital wards, whereas specialist palliative care and end
of life care is defined is the management of unresolved
symptoms and more demanding care needs, including
complex psychosocial, end of life and bereavement
issues (RQIA 2016).
If we apply this to a patient’s journey, it is quite
possible that a patient may transition from generalist to
specialist services.
The project
In 2017, the Royal College of Occupational Therapists
Specialist Section – Oncology and Palliative Care
(RCOTSS-OPC) set out to explore the experiences of
OTs delivering palliative care and palliative rehabilitation
across generalist and specialist services.
A pilot was conducted on twitter (#OTalk 2017) to
explore the interest in the topic. Following this, ethical
approval was obtained to undertake seven focus groups
across the UK.
The focus groups were based around four key
questions: Whose responsibility is it to deliver palliative
care and palliative rehabilitation? What skills do OTs have
to meet the needs of palliative patients? When would
generalist OTs refer to specialist palliative OTs? What
training have OTs had in palliative care?
178 participants attended and an additional session
was conducted via Facebook live.
P
alliative and end of life care is an increasing
priority for healthcare in the UK (NHS England
2015; Welsh Government 2017). Occupational
therapy’s core philosophy aligns well with a
palliative care approach, as both consider the physical,
psychosocial and spiritual needs of the individual in order
to improve quality of life (WHO 2018; RCOT 2018).
Occupational therapists are in a unique position to
deliver palliative care and palliative rehabilitation, with their
dual training and person-centred approach to maximise
a person’s occupational engagement to achieve personal
goals (COT 2004; AOTA 2015).
Occupational therapists who work within specialist
palliative care services face challenges to deliver palliative
care and palliative rehabilitation. First, it is estimated that
there will be a 42 per cent increase in the demand for
palliative care services by 2040 (Etkind et al 2017).
The second challenge is ensuring that specialist
palliative occupational therapists are seeing the patients
that need specialist interventions. Using a health
population, it is suggested that only five per cent of the
population will require specialist palliative care input, 30
per cent will require a targeted service, with the remaining
65 per cent likely to have their needs met by generalist
palliative care services (Collins 2018; Gascoigne 2012).
Generalist palliative and end of life care is delivered
by multidisciplinary teams in community settings and