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13. Palliative care
In order to preserve acute and emergency care in the primary and secondary care settings at the peak of a pandemic, it will be necessary to restrict the types of treatment available to patients with pre-agreed clinical conditions and levels of illness. This will inevitably result in significant numbers of people with advanced terminal illnesses in need of symptom relief and comfort.
The ability of the primary and secondary care services to meet this increased demand for palliative and symptomatic care will be critical to support the difficult decisions that clinicians in primary and secondary care will need to make during the peak of a pandemic, if acute and emergency care services are to be maintained.
The actions needed to support palliative care in this situation may involve the bolstering of community services by hospital staff or the provision of areas within a hospital where palliative care can be delivered. Some voluntary sector organisations have particular expertise in this area and it is likely that they would be able to provide valuable insights into how this type of care might be delivered and the role that they might be able to play in supporting this work. The provision of increased palliative care may require increased amounts of certain drugs, and this issue will also need to be addressed. It will be for the healthcare system in each area to agree how this type of care will be addressed, taking account of the unique circumstances of each locality and the guidance within primary care, 61 and to make this part of local surge plans.
Unless those patients for whom active, curative treatment is no longer deemed appropriate can be supported, the provision of acute and emergency care could be severely compromised.
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