Multi-Disciplinary Team overcomes COVID-19 challenges

The hospice’s Multi-Disciplinary Team (MDT) has been helping patients and their families with a host of concerns during COVID-19.

From providing essential drugs and assistive equipment to advising on pain management, the team has been there for patients in person, at the end of a phone and through virtual media. And in doing so, they have ensured they can support people however they have needed it despite the challenges of the pandemic and lockdown.

The team, which celebrated its tenth anniversary last year, is made up of different health professionals specialising in occupational therapy, physiotherapy and pharmacy. By working together with other John Taylor Hospice colleagues, the members of the MDT can use their expert knowledge to ensure holistic care for patients and their loved ones.

But when the role can include prescribing medicines, assessing for specialist equipment and easing mobility issues, how have they been able to support people during lockdown?

Occupational Therapist Faye Collins explains: “We have worked in some different ways from how we usually work to ensure we could help patients while they stayed at home.

“At the beginning of COVID-19, a lot of our patients were quite scared about people coming to their homes. A lot of them were shielding and so were being told to restrict visits – and yet they still needed to be seen or assessed.

“So we looked at ways of doing this virtually where we could. In a lot of cases people were happy to talk over the telephone and have video calls and there is all kinds of technology we could use. We found that many patients and families actually welcomed being assessed this way.

“So, for example, if an occupational therapist is looking at what equipment would help someone we would usually look at what they currently have and assess for what they now need. Instead of visiting to do that, we have been completing a lot of assessments over the phone and asking people to send us photos of what they are struggling with. So if we are looking at a raised toilet seat they can send us a photo of their bathroom so we can see how it would fit and what options are available.

“There have been some patients who have needed visits, particularly for physiotherapy. As lockdown has eased we are now making more visits but a lot of patients are still happy to carry on using technology rather than visits where possible.”

One of the most important adaptations has been the launch of Hospices of Birmingham and Solihull (HoBS) which has seen John Taylor, St Mary’s and Marie Curie West Midlands Hospices joining together to provide a single service during COVID-19.

“That has meant one therapy team across the three hospices which has really helped in terms of working together,” says Faye. “It means we can share resources and it gives patients and other health professionals access to a lot of specialist knowledge and support. So, for example, we put together a library of videos which we could share with patients if they needed additional information about how to use specific pieces of equipment.”

“At the beginning of HoBS we piloted weekend and Bank Holiday cover from the MDT and we are now still providing Bank Holiday therapy cover from the teams across the three hospices. HoBS has really helped us build strong collaborative relationships with other hospice therapy teams.”

The teams also put in practical measures to ensure patients could access what they needed despite lockdown. As soon as lockdown was announced the hospices increased the amount of assistive equipment they held in their buffer stores to ensure aides which would make such a difference for patients could be rapidly available.

Hospice pharmacists also worked with their colleagues in the community to ensure stocks of specific drugs were readily available in the community to support palliative and end of life patients. Through HoBS, patients can access these crucial medicines out of hours, ensuring they can receive support when and where they needed.

MDT during COVID-19

John Taylor Clinical Pharmacist Tarun Nayyar explains: “This has allowed more patients to receive prompt, high quality end of life care within their home setting and prevent out-of-hours GP visits or admission to hospital.

“The specialist palliative care pharmacists at John Taylor and Marie Curie Hospices provided a joint 24/7 rotational on-call service between April and June. This service, accessible via HoBS, meant that healthcare professionals such as GPs, district nurses and palliative care nurses can benefit from rapid access to expert knowledge that could help manage clinical queries relating to complex symptom control and medicines management at the end of life.”

Many of the changes such as improved collaboration and better use of technology will help patient care going forwards.

“COVID-19 had made us work in some different ways but some of these, like better use of technology, are actually good things,” adds Faye. “We have also looked at how we can develop some services so, for example, we have created some relaxation videos which are now available to everyone on our website and we are updating booklets and making more information films to help patients more readily access the advice and support they need.

“Despite the problems we have faced with COVID and lockdown, the focus has always remained on the patients and ensuring they have the care they need. Now we need to look at some of the things which have worked well and how we can build on them to continue to improve our services for patients.”

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What our patients think

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“At such a heartbreaking and difficult time, the nurses and care assistants knew exactly what to do and to say – we’d have been lost without them. The care they provided for my beautiful wife was second to none and I’ll be forever grateful.”

Roger Perks

“Nothing is too much trouble”

“I can’t thank hospice teams enough. From fitting grab rails in my house and ordering a reclining bed, reviewing of all my medication, providing me with new medical equipment and even helping to organise domestic help for us at home – they’ve covered everything but are always willing to do even more.”

Jackie Bannister

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“The support I get is truly is invaluable and I honestly don’t know where I’d be without them. I’m able to talk openly about my illness and ask for advice and support if I need it. I’ve made some incredible friends and the hospice is a very special place full of laughter and kindness. “

Liz Warren

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