Lights, camera, stop! What to consider when television crews come to a hospital

Fly-on-the-wall medical documentary programmes are becoming increasingly popular. In fact, they have become a mainstream televisual phenomenon. When things go well, it can be a valuable way of conveying key messages to viewers, for instance on the importance of a variety of public health measures. It can also be a positive way to portray the dedicated work of NHS staff, increase trust between the public and the medical profession, and importantly also show the complexity of healthcare and the real-life challenges that are faced. The article outlines some of the key areas to think about before engaging

P-221 Working with hospices to ensure patients' digital legacy wishes are adhered to

The Digital Legacy Association (DLA) was launched at last year’s Hospice UK conference. Their work is focused on raising awareness and improving processes in areas relating to death and the internet. Over the last 12 months the DLA have published a free framework, developed training workshops, launched a free hospice inpatient resource, run ‘pop-up’ events, organised a Digital Legacy conference, carried out different forms of research and campaigned highlighting that end of life and bereavement in relation to the internet and electronic devices is an area requiring thought, governance and change. The DLA spend a lot of time working with hospices, CCGs, charities and trusts. The outcome is improved knowledge and skillsets applied at an organisational and/or at an individual level. The diffusion of the DLAs information occurs by supporting professionals through a variety of different channels. In turn this helps professionals to better support patients and their families. The DLA’s work often revolves around conversations and campaigning. Their recent work for Velindre NHS Trust, Aneurin Bevan UHB & Byw Nawr included building a TalkCPR awareness website. The goal of the TalkCPR campaign is to help increase dialogue around CPR and DNACPR within Wales. The TalkCPR campaign was recently nominated for a NHS Wales award. This paper will document the DLA’s journey over the last year, explain how they use creativity to address end-of-life and document how they plan to support every UK hospice over the course of 2017

Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues

Abstract Background Out-of-hours general practitioners (GPs) cover the community over a significant proportion of a given week, and palliative care patients are seen as a priority. Little is known about how well these GPs feel supported in their line of work and whether communication exchanges work well for the proportion of their patients who have palliative care needs. For this study, GPs who provide out-of-hours care were interviewed in order to explore factors that they identified as detrimental or beneficial for good communication between themselves, patients, relatives and other professionals, specifically to palliative care encounters. Methods Nine GPs were interviewed using face-to-face semi-structured interviews. All nine GPs worked regular out-of-hours sessions. Data from transcripts was analysed using Interpretative Phenomenological Analysis. Results A predominant theme expressed by GPs related to constraints within the system provided by the local private company owned out-of-hours provider. A strong feeling of 'being alone out there' emerged, with some GPs more willing to call for help than others, and others expressing their concern at access to pharmacies and medication being very inconsistent. Out-of-hours GPs felt left alone on occasion, unable to access daytime services and not knowing who to call for advice. Information hand-over systems from in-hours to out-of-hours with regard to palliative care were felt to be inadequate. Out-of-hours doctors interviewed felt left out of the care loop; handover sheets from specialist palliative care providers were a rarity. Conclusions Out-of-hours services need to be mindful of the needs of the GPs they employ, in particular relating to the palliative care they provide in this setting. Other healthcare professionals should aim to keep their local out-of-hours service informed about palliative care patients they may be called to see.</p

PL 3 Palliative care - technology & new media

Background/aims: In this plenary past, present and future trends that can enable patients, carers and healthcare professionals to make good use of emerging technologies are explored. Media such as video, virtual/ augmented reality, artificial intelligence (AI) and even the humble QR code, have already had a significant impact in our quest to make aspects of palliative care more understandable and transparent. Methods: Working with patients, carers and students at a tertiary cancer centre has led to several studies and QI projects involving new media, including the use of AI. For instance, a virtual reality 360 degree radiotherapy experience is now available on the hospital trust’s own YouTube channel, and is very highly accessed. But even day-to-day technologies, such as digital remote video consultations, have quickly led to new challenges regarding how we best communicate when using technology. Advance & future care planning can be demonstrably enhanced when outpatient or bedside video technology is used to help people understand complex topics like Do Not Attempt CPR (DNACPR) decisions, and we have used QR codes to link to trusted resources. Digital legacy planning has quickly become an important topic of conversation for healthcare professionals, social workers and welfare rights officers. Results: New technologies offer exciting possibilities for patient/carer engagement in all the multiple areas that palliative care covers. New media are now frequently used by patients for information gathering. People will not always read the paper information leaflets they are handed, but instead will enquire on social media, YouTube and more recently on AI platforms such as chat GPT to find answers to their questions and problems. The areas that can be covered by technology are vast, and may allow clinicians to focus more on the inter human aspects of communication, whilst technology ’does the rest’. Conclusions: Rather than just consider new technologies in our field of expertise, we need to accept that they are already firmly established in patients’ homes and on smartphones, frequently used in an unstructured way. Setting up local systems, including the AI project we have in use in our hospital trust, can be beneficial. But it can also be cumbersome, for instance when having to feed thousands of possible question/answer scenarios into the software. Therefore, collective approaches, ideally with mass participation, will ensure that such new media and technologies can be peer-reviewed and evidence based

Viral- International online peer support & learning in palliative care

Aims: In Wales, the Advance & Future Care Planning (AFCP) strategic group oversees the national direction for advance care planning. The aim is to establish a peer-supported campaign to effectively inform people about AFCP. The group includes patient representation and has had a strong focus on promoting person-centred AFCP via new media. Methods: Several social media campaigns, for instance #TalkCPR, #FutureCarePlanning & #WhatMattersMost, have been led & co-directed by technology-savvy patients & carers. YouTube videos on the complexities of resuscitation & AFCP education have been co-created by patients. Apps, websites, YouTube channels & hashtags were created including https://advancecareplan.org.uk, www.wales/nhs.uk/DNACPR, #TalkCPR & http://talkcpr.com. Patient groups helped write scripts for explanatory videos. A national conference in 2019 further helped to set direction. Resources have been accessed over a million times, including countries like Lesotho. Results: The online content has had a worldwide reach & highlighted Welsh advance care planning materials. As an example, a patient wrote about the resources on a medical journal site, “Twitter helped me decide that I’m not for resuscitation” in the BMJ ‘What your patient is thinking’ series. The article was downloaded over 10,000 times, with readership breakdown of 61% members of public, 29% practitioners, 8% scientists & 1% journalists

Lights, camera, stop! What to consider when television crews come to a hospital

Fly-on-the-wall medical documentary programmes are becoming increasingly popular. In fact, they have become a mainstream televisual phenomenon. When things go well, it can be a valuable way of conveying key messages to viewers, for instance on the importance of a variety of public health measures. It can also be a positive way to portray the dedicated work of NHS staff, increase trust between the public and the medical profession, and importantly also show the complexity of healthcare and the real-life challenges that are faced. The article outlines some of the key areas to think about before engaging

Malnutrition and bilateral central retinal vein occlusion in a young woman: a case report

Introduction: Can vitamin B12 and folate deficiency cause central retinal vein occlusion? We conducted a literature search to find out whether nutritional deficiency of vitamin B12 and folate can lead to impaired vision. Case presentation: The patient in the article presented in an eye-casualty department in the North East of England with gradual painless visual loss over six weeks. She was found to have bilateral central retinal vein occlusion with significant anaemia and vitamin B12 and folate deficiency. Conclusion: Vitamin B12 and folate deficiency can lead to elevated levels of homocysteine. We found a large amount of published data relating central retinal vein occlusion to elevated homocysteine levels, but there was a lack of conclusive evidence for this association Patients should be asked about their dietary history where a thrombotic event is suspected or confirmed

Emergencies in oncology and palliative care

This article introduces a series on emergencies in oncology and palliative care, focusing on recognition and management of emergency scenarios during the care of cancer and palliative care patients. Palliative care emergencies can be divided into two categories: imminently life-threatening and potentially resulting in a persistent and worsened morbidity. A calm and efficient approach is achieved by anticipating and meticulously planning for potential events, for example, a haemorrhage from a fungating tumour near a major vessel