AS part of our ongoing series of features set in and around the DGH our reporter talks to the staff in the specialist palliative care team about helping people face up to the fact they are not going to be cured.
WITHIN five minutes of talking to the specialist palliative care team at the DGH almost all my preconceptions of end of life care have been well and truly turned on their head.
Far from the morose, sombre atmosphere you might expect when meeting a group of people to discuss helping patients prepare to die, the atmosphere is upbeat, enthusiastic and above all, hopeful.
Working with people who know their time is limited will, I am told, always be an emotional challenge.
But Dr David Barclay and his colleagues are quick to point out that while their job is clearly a difficult one, their role also has the power to be uplifting and is ultimately hugely rewarding.
“Of course it can be difficult,” he says, “and we are all lucky we have a good team here who support each other, but there are also lots of positives.
“Palliative care is all about helping people get the most out of the time they have left and being able to do that is great.”
His colleague, fellow doctor Ferida Malik, went further.
“It is a privilege to be able to help people,” she said. “Often our focus is on quality of time over quantity and we do what we can to help people achieve the best possible outcome.”
In the last year the team helped around 600 people, with a 70-30 split between the cancer patients who have traditionally benefited from palliative care and people who suffer from other life-limiting conditions.
As well as the two doctors, who work two and a half days a week and are largely funded by St Wilfrid’s Hospice, there are also a pair of specialist Macmillan nurses who offer both expertise and support to people coming to terms with the terminal state of their condition.
Jayne Winter and Linda Richardson together form a vital cog in the palliative machine - working closely with other locals organisations to ensure of a joined up, united approach to end of life care.
That partnership includes working with the local hospice, Macmillan nationally and social services and community nurses and is an approach which, according to Dr Barclay, has drastically improved matters here in Eastbourne.
“We are lucky,” he said, “in the sense that we have different people on hand to share expertise and work together to get the best outcome for the patient.”
For some people that can mean working with the hospice at home team to allow people to die at home, in other cases it could be prescribing medication to make their remaining months more manageable.
For everyone though, the key is offering people choices of how what they want to do and where.
“We don’t just deal with people in the final hours of their lives,” explained Dr Barclay, “in fact, lots of the people we help have weeks, months or even years left to live.
“For doctors treating these patients it can be difficult to accept the situation knowing you cannot do anything to cure.
“There is a cultural belief that hospitals should be able to make you better but sadly, that is not always the case.
“At one time or another everyone will have to face up to having a life-limiting illness.
“Our job is to help them move on from this and get the most out of the time they have left.”
The team are remarkably positive considering the fact tragedy and death greets them at work every day of the year and it is clear it takes a special sort of person to work in palliative care.
But, while the end result, in clinical terms, is always the same, the journey patients undergo makes the job among the most rewarding in the NHS.
Each member of the specialist palliative care team has their own story about why they moved into that specific field of work, but none sums up the staff’s approach and attitude better than that of Dr Malik.
She revealed, “When I was training there were patients I still remember – including one in particular.
“He was told he would not get better. The palliative consultant spent an hour talking to him and by the time he left he had regained a sense of hope for the future.
“I looked at the impact that doctor had managed to have on the patient in just one hour and thought I would like to be able to make a similar impression.
“It can be difficult. We are trying to change people’s attitude and often we spend as much time with the family as we do the patient.
“We work together to set goals and explain what is achievable and it is great to help people to do things they did not think they would be able to.”
Dr Barclay sang from a similar hymn sheet. “This is what I always imagined being a doctor was about.
“It is very patient centred and although all our patients will die we strive to them die well and with dignity.”
Jayne added, “A lot of people come to us with fear. They are frightened when they are told they are being referred to a Macmillan nurse and palliative care.
“Hopefully, after meeting us, that fear and apprehension has been replaced by hope.”