P-12 On the frontline: the experiences of one supportive and palliative care team (SPCT) during the first 12 months of the COVID-19 pandemic and what we learnt for the future

Abstract

<h3>Introduction</h3> Early in the pandemic, 26% of UK COVID-19 hospitalised patients died, often with high symptom burden. However the needs of non-COVID patients also had to be met. We describe the experiences of one hospital SPCT and lessons learnt. <h3>Methods</h3> Retrospective case series review of all patients referred to SPCT (COVID (C) &amp; non-COVID (NC)) in 1st &amp; 2nd pandemic phases. Variables collected: demographic/clinical data, AKPS/POI, outcomes. Semi-structured anonymised online survey of SPCT regarding working experiences/needs during both phases. Summary statistics describe 1st and 2nd phases and compare data between phases (and with same time period year before COVID). <h3>Results</h3> Total of 1159 (863NC/296C) patients in 2nd phase (Sep 20-Feb 21); this compares with total 956 same time year before and an increase from 904 (856NC/48C) in 1st phase (Mar-Aug 20). SPCT were involved in six times the number of patient episodes in second phase compared with first phase (296 vs. 48) and in 46% of all acute hospital COVID deaths (increase from 30% involvement in first phase). Mean AKPS was 26% in 1st phase, with 80% dying compared with AKPS 18% and 82% dying in 2nd phase. Mean caseload duration 4.1 vs. 2.3 days (1st/2nd phases). Nearly half (5/11, 46%) of team self-isolated during second phase compared with 1/3rd in first phase. Second phase team experience changed with more referrals and more symptomatic dying patients who were rapidly deteriorating. First phase helped second phase with team confidence in managing patients and preparation, but the team highlighted high caseload/symptom burden and personal impact. Improvements instituted include daily cross-site SPCT morning meetings, 7-day CNS service, flexibility using virtual meetings and measures sustaining team wellbeing. <h3>Conclusions</h3> SPCT were busy with COVID patients whilst still supporting numbers of Non-COVID patients. Future focus centered on sustaining work flexibility and team wellbeing.