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Nurse specialists 'crucial' to improving access to palliative care

Disease-specialist nurses are 'crucial' to the provision of palliative care but may face barriers in providing it, a report by Marie Curie Cancer Care has found.

Specialist nurses are 'crucial' to the provision of palliative care but may face barriers in providing it, a report by Marie Curie Cancer Care has found.

The report revealed that as many as 110,000 people each year do not receive palliative care appropriate to their needs each year. According to the report, care for patients with illnesses such as heart failure, COPD, dementia, and liver disease are of particular concern, as this group are less likely to receive palliative care than patients with cancer. This is due to these diseases are subject to more unpredictable progression, while cancer tends to involve a recognisable decline.

It states that nurse specialists are 'crucial healthcare professionals and can coordinate assessment of need, sensitive discussion and access to appropriate care.'However, the report cited evidence that nurse specialists also face barriers to providing palliative care, such as a lack of training and the attitude of other healthcare professionals.

Among the recommendations provided in the report, it states that healthcare organisations should ensure disease-specific nurse specialists receive training and support to enable them to deliver care to terminally ill patients. This is because patients are often not recognised as needing palliative care by healthcare professionals.

Dr Jane Collins, chief executive of Marie Curie, said: 'Palliative care can benefit people with many different illnesses and at different times in those illnesses. Healthcare professionals simply don't receive enough training to be able to recognise when someone needs palliative care or when someone is dying.'

The report also states that the approach to palliative care of allied professionals can prevent nurse specialists from referring patients for palliative care and providing it. Using the example of cardiovascular nurses, it suggests that the 'most significant challenge' in providing palliative care for heart failure patients was the lack of support from cardiologists and senior members of local trusts. The report states: 'Nurses felt that without this support, their service was unlikely or indeed unable to achieve its aims.'

Professor Rob George, president of the Association for Palliative Medicine of Great Britain and Ireland, said: 'It is not that we don't have the models and approaches to care, it's that the conversations are not joined up, and not just at the bedside, but between those needing care and those commissioning and providing it to design and deliver services and support that makes sense at that bedside.'