Specialist palliative care needscan change over time. Frequently the progressive nature of the disease necessitates increasing SPC input. However, in some patients needs may decrease or stabilise such that they no longer require specialist palliative care. In the latter group it is appropriate to consider discharge with ongoing care from other health care providers. Such decisions will be made following multiprofessional discussion, with the patient and family being involved in the discharge process. The patient, the referring team and all relevant health care professionals will be advised of the decision to discharge in advance. It is important to note that patients can be re-referred should they develop specialist palliative care needs once more.
A patient may be discharged from specialist palliative care if:
1. There is a change in disease status such that the patient no longer has any specialist palliative care needs e.g.
- Investigations reveal less advanced disease than previously thought
- Following response to treatment
- Disease evident as only slowly progressive
2. There is symptomatic improvement such that the patient no longer has SPC needs.
3. Following initial assessment, it is agreed that they do not have SPC needs and ongoing needs are more appropriately met by other health care agencies.
4. The patient, following informed discussion, expressly requests discharge from SPC services.
5. The patient or family persistently prevent effective specialist palliative care input e.g. restricting access for assessment. The SPC team are, however, always available to offer support to involved healthcare professionals.
When a patient is discharged from the specialist palliative care service, their General Practitioner, hospital team and other professionals as appropriate are informed in writing. Patients can be re-referred at any time by their GP or hospital or Primary Care team.