New ways of working in palliative and end of life care: crossing traditional acute hospital occupational therapy boundaries.

In 2013, a successful funding bid to Macmillan enabled a new specialist palliative occupational therapy (OT) service to be created. In 2016, the team were recognised for innovative practice by winning an Abbvie Healthcare Award and through inclusion in a new occupational therapy report (College of Occupational Therapists 2016). We are sharing our experience of this new service to encourage other clinicians to innovate. All palliative patients should have access to client-centred care coordinated between acute and community settings (NHS England 2015). With increased accident and emergency (A&E) presentations, pressure on acute hospital beds is growing (Murray 2016). Occupational therapists are uniquely trained to work across health and social care settings and can achieve reduced length of stay and avoidance of unnecessary admission to hospital by providing a quality, safe discharge (College of Occupational Therapists 2016). The introduction of the new palliative occupational therapy team, working across A&E, acute medical wards, base wards, outpatient clinics and community settings, is enabling these issues to be addressed. By sharing our experiences of building key acute, community and voluntary sector relationships, we can demonstrate reduced duplication, increased efficiency and seamless patient care. We aim to demonstrate how to develop palliative specific skills, including self-management of symptoms, advance care planning, emotional support and rapid discharge planning. We aim to share strategies to collect qualitative and quantitative outcome data to evidence improved patient and carer outcomes and cost savings, essential in driving services forward in an everchanging, pressurised NHS. [ABSTRACT FROM AUTHOR]