Palliative development post in the Borders is more than just a PATCH

Better palliative care...has been a boon for Janice Logan, PATCH course facilitator (left) with course participant senior charge nurse, Andrea Johnston.
Better palliative care...has been a boon for Janice Logan, PATCH course facilitator (left) with course participant senior charge nurse, Andrea Johnston.

A partnership between a Scottish charity and NHS Borders has reaped results in the last two years.

Palliation and the Caring Hospital (PATCH) has worked in partnership with NHS Borders, St Columba’s Hospice, Edinburgh, and Queen Margaret University to deliver tailored and targeted staff development.

Some 24 local nurses have participated in the PATCH course – learning over the course of five days how best to help patients receiving palliative care.

This was followed by six months of mentored work on personal development relevant to their individual needs and clinical work.

Now, for the first time, PATCH has agreed to fund a part time NHS Borders post in the hopes of helping even more nursing staff.

Dr Gordon Paterson, PATCH director, said: “A recent evaluation of our courses identified a continuing need for further investment in staff development related to palliative care.

“So the Board of PATCH has agreed to commit £60,000 over the next two years to fund a PATCH practice development nurse for the Borders.

“It is the first time we have funded an NHS post but we believe it is the best way to help even more staff.

“The PATCH nurse will be on the wards at Borders General Hospital two and a half days a week.

“They will be able to target staff development to suit each ward’s clinical needs.

“We know many more nurses wanted to attend the PATCH courses. The problem was trying to cover their shifts.

“In the past two years, PATCH has paid for nursing staff to cover shifts, as well as the costs of delivering the course.

“Much of those funds were raised in the Borders by an enthusiastic Friends of PATCH group, which organised an impressive range of events including a musical evening, golf competition, tea parties, lunches and dinners.

“This income has been supplemented by grants from charitable trusts.

“Employing a dedicated PATCH development nurse, though, will enable many more nurses to benefit.”

Each week in the Borders, a number of individuals will learn that they have a life-changing and potentially life-limiting illness. This creates a need for skilled and caring support to help them cope with the physical, emotional, financial and social effects.

And palliative care lies at the heart of this support network.

Although most people express a wish to die at home, for a variety of clinical and domestic reasons this may not be possible. As a result, more than half of deaths in the Borders occur in hospital.

The Margaret Kerr Unit at Borders General Hospital serves as the focus of specialist palliative care. However, the unit has limited capacity so not all patients will receive end of life care there.

Instead, they receive compassionate end of life care in other wards at BGH and community hospitals. It is for that reason that PATCH and NHS Borders saw the need to invest in staff development, helping nursing staff from many clinical areas deliver quality palliative and end of life care.

It has been a huge success and the new PATCH nurse will simply build on that.

Janice Logan, programme lead and lecturer in Palliative Care at St Columba’s Hospice, said: “The course enabled registered nurses to explore, reflect and build on their experience of palliative and end of life care practice.

“This was done both in the classroom and by shadowing members of the specialist palliative care teams at the Margaret Kerr Unit and St Columba’s Hospice.

“Key to its success was the participant-generated content, with nurses sharing their real life experiences with each other.

“This enabled learning to be meaningfully applied to practice and contributed to developments in palliative and end of life care practice within the participants’ practice areas.”

NHS Borders is delighted to be extending its partnership with PATCH.

Dr Annabel Howell, associate medical director and palliative care lead, said: “It will enable us to develop a new educational post which will help to enhance the skills of all staff in palliative and end of life care.”

And Nicky Berry, director of nursing, midwifery and acute services, added: “We have a great relationship with PATCH which will now continue well into the future. This will enable us to further develop staff skills in palliative and end of life care.”

Staff praise for the course

NHS Borders staff have nothing but praise for the PATCH course. We spoke to two participants.

Julie Cleland, a district nurse at Selkirk Health Centre, said: “Although I have worked in community for a long time and have palliative care experience, I found the course very beneficial.

“The week got us together as a group to hear about and share our experiences from different areas of nursing, which was a very useful experience.

“I would like to think we might in the future keep in touch and continue to share experiences.

“We have gained knowledge in a variety of areas such as symptom control, ethics and psychological issues, to name just a few.”

Andrea Johnston, a senior charge nurse at Kelso Community Hospital, agreed saying: “I enjoyed the programme immensely and I’m thankful to have been able to be part of it. The small group provided a safe place to express past experiences and to enable learning and development.

“I also feel privileged to have been able to spend time at St Columba’s Hospice and the Margaret Kerr Unit.”

In addition to the staff development project, PATCH and the Friends of Kelso Community Hospital have also jointly funded the purchase of a pull-down bed so that a relative wishing to stay overnight to be with a patient can now do so.

PATCH was established in Dundee in 2013. It is dedicated to providing the stimulus, funding and experience to establish specialist palliative care services in Scotland.

It has supported a number of projects related to education and training, research, development and innovation.

To find out more, visit patchscotland.com.