Douleur et soins palliatifs. Dossiers progressifs et questions isolées corrigés 

 ROSTAING-RIGATTIERI, Sylvie ; VARIN, Dominique ; TOURNIAIRE, Barbara ; PASSARD, Andréa, 

Elsevier Masson, novembre 2015

Cet ouvrage permet aux étudiants de se préparer aux épreuves des ECNI en privilégiant des batteries d'entraînements de plusieurs types : cas cliniques progressifs accessibles, également en ligne, questions isolées QCM ou QROC, TCS et LCA. L'ouvrage est constitué de 2 parties : l'une est composée des énoncés des entraînements classés par typologie ; l'autre propose les corrigés assortis de grilles de correction, précisant les items traités et les recommandations existantes, ainsi que des fiches de synthèse qui rappellent les points clés, privilégiant les algorithmes et l'explication de la démarche du raisonnement clinique.

BILLET Pour les soins palliatifs et l’accompagnement 2015 a été riche en événements La Sfap a été entendue dans les débats Et a pu témoigner de ce qui va ou pas   La nouvelle loi est dans les mains du parlement Et le ministère va débloquer de l’argent Nous avons maintenant à travailler ensemble Sur les justes valeurs de ce que bon nous semble   L’accompagnement des personnes en fin de vie Reste préoccupation première et définie Que nous souhaitons poursuivre et encore développer A travers formations et culture diffuser   Ces derniers mois plusieurs écrits ont été lus Entraînant confusion profonde et continue Nous n’avons pas besoin d’angoisse anticipée Mais d’énergie soignante et non désespérée   Gardons foi au futur et en ce nouvel an Et restons habités par le moment présent Le plan ministériel est à considérer Pour les soins palliatifs comme une belle avancée   Bonne et heureuse année à vous tous adhérents En l’espérant ponctuée d’agréables moments                                                       Nathalie Favre, Vice-Présidente de la SFAP

Digital technology should be better utilised to give those facing terminal illness more control over their care

08 December 2015

News | Care

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  Health and care staff need digital skills in order to support patients to make the most of digital tools and technology

Health and care staff need digital skills in order to support patients to make the most of digital tools and technology

A cross-sector project to help give older people facing the end of life more control over their care is one of a number of proposals put forward today on how to increase digital inclusion across the NHS.

Earlier this year, Health Secretary Jeremy Hunt tasked Baroness Martha Lane Fox to look into how to increase the take-up of internet enabled services in health and care.

Today Martha Lane Fox will present her recommendations to the National Information Board leadership summit, and lead a discussion on potential strategies for widening digital participation.

Those with the most health and social care needs are often the most digitally excluded – which is why one of Martha’s four recommendations is to “reach the furthest first”.

“I would like to see a massive transformation using internet enabled technologies, focussing on those who are digitally excluded. Older people are a traditionally digitally excluded group and people with life-limiting illness have high health and social care needs,” she explains.

Martha proposes a cross-sector project, working with older people with life-limiting or terminal illness facing the end of life, to give them “more control over their healthcare destinies.”

Her organisation Doteveryone is working with NHS England on a prototype which will demonstrate how internet-enabled technology can give older people with life-limiting illnesses greater control in planning and managing their care.

Development of this self-management tool for patients and carers, which will link up with electronic palliative care coordination systems, will begin in 2016 – with the code being made open and accessible for all.

Those behind the project hope it will show how, when you reach the furthest first, you can reach everyone, as well as provide a new model to show how to build and scale technological development in health and social care for the benefit of all.

Other recommendations put forward today include:

• Free Wi-Fi in all NHS buildings to allow hospital patients to self-monitor their conditions using apps and maintain contact with social networks, which can support recovery and help them to stay in contact with family and friends.
• Building the basic digital skills of the NHS workforce so they can make the most of digital tools and technology and feel confident to recommend these to patients.
• At least 10% of registered patients in each GP practice should be using a digital service such as online appointment booking, repeat prescriptions and access to records by 2017.

Today's recommendations have been welcomed by the Digital Legacy Association, a research and training organisation which supports the end of life and hospice sector in areas relating to digital assets, digital legacy and digital bereavement.

CEO and founder of the Digital Legacy Association James Norris said: "We are delighted that today’s digital recommendations by Baroness Martha Lane Fox place such a strong emphasis on utilising today’s communication technologies.

"The recommendations include aiming to drastically improving IT literacy within the NHS workforce, setting figures on patient internet adoption and providing free Wi-Fi in every NHS building. The goals set appear to be both challenging and achievable. 

"The internet has been the biggest catalyst for change since the industrial revolution. It has changed the way in which we communicate with one another and consume information. It can also significantly speed up the amount of time it takes to carry out administrative tasks within healthcare settings.

"If the recommendations are adopted it may significantly help to improve hospital and hospice care within the UK. Furthermore, areas such as patient satisfaction may also improve."

Health Secretary Jeremy Hunt said: "Creating an NHS which is digitally fit for purpose in the twenty-first century is a key priority for this government. New investment of £1 billion in health technology announced in the autumn statement will help us to achieve this – making sure that patients and staff can access the services they need, helping to free up time and reduce costs."

Tim Kelsey, National Information Board Chair and NHS England national director of patients and information, added: "Digital health tools can dramatically improve people’s lives and wellbeing. These bold challenges to the system to ensure that every person in the UK benefits are very welcome, and will galvanise work already underway to put power in the hands of patients, enabling them to take control of their care and improve their health."

Hundreds of people in Scotland die while waiting for social care packages

Author: Tom Moran

14 January 2016

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A freedom of information request by motor neurone disease campaigner Gordon Aikman has revealed that at least 276 people in Scotland died last year while waiting for their social care packages to be arranged.

NHS Scotland figures indicate that a large proportion of the people waiting for social care to be provided – around 70% – are over the age of 75. There were 1,294 people waiting in hospital for social care in November 2015.

Of the 276 who died while on the waiting list, 95 were from the Edinburgh council area, the highest figure from any single council. Services in Glasgow are contracted out to a private company, and therefore not subject to freedom of information legislation; 26 of Scotland’s 32 councils responded to the request.

Aikman, who has motor neurone disease and receives visits from carers three times a day, said his findings showed "a cruel crisis in care" which he attributed to council budget cuts.

"Behind these figures are real people with stories of desperation, misery and indignity," he told the Scotsman. "Imagine it was your mum or your son waiting months for the help they need to live their life."

He added: "Given our parliament now has revenue-raising powers, it need not be this way."

His sentiments were shared by Richard Meade, head of policy and public affairs in Scotland for Marie Curie.

"Marie Curie patients have experienced delays in getting social care packages, which can impact on their care and place of care. This is not acceptable, particularly for those living with a terminal illness when time may be short," he said.

"Social care support is vital in enabling people to be cared for and die at home if that is their choice. The integration of health and social care in Scotland must address this and ensure that people living with a terminal illness and their carers get the care and support they need from the time they need."

The health secretary, Shona Robison, said that the Scottish government would work with councils to improve care and explained that there would be a £250 million investment in social care in next year’s budget.

"The Scottish government is joining up health and social care for the first time to ensure that our health boards work seamlessly with local authorities to deliver the best possible care," she said.

"We are committed to supporting councils, NHS boards and integrated health and social care partnerships to ensure that their social care packages are arranged effectively to meet the needs of local people."

Doctors call on government to prioritise end of life care

Author: Caroline May

14 January 2016

News | Research

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Publishing new research which highlights a ‘postcode lottery’ of end of life care in the UK, the British Medical Association (BMA) is calling on the government to prioritise improvements in end of life care.

"Doctors need the time, support and sufficient training necessary for caring for people at their end of life, and patients must be able to access a high quality of end of life care wherever they live, whatever their medical condition."

Launched in November 2014, the BMA’s latest research project set out to explore a number of practical and ethical issues around end of life care and physician-assisted dying.

As part of this, member of the public and doctors were invited to take part in a series of 21 discussion events around the UK last year.

The final report on this research, published today, reinforces many of the findings from other recent reports and inquiries – the variability in the quality and availability of end of life care, the need for better communication between doctors and their patients, and the importance of coordination of services in ensuring good outcomes for patients who are dying.

Noting that the UK has "led the world in developing comprehensive and holistic care for people whose lives are coming to an end," BMA representative body chair Dr Ian Wilson said that the research highlights how "the provision of end of life care remains variable, dependent on a patient’s geographical location, their condition, and their knowledge of local services."

Adding: "One member of the public who had recently suffered a bereavement described the quality of end of life care as a postcode lottery – a sentiment shared by the public and doctors alike.

"This is completely unacceptable. What came through loud and clear during the study was that people want to be treated as individuals, with care and compassion, and it is very important to many people that their families are involved in the process, but the current system doesn’t always enable this."

Communication was also highlighted as a particular area of concern. While doctors recognised that communication between them, patients and their family could be critical in making end of life easier to understand and accept, many doctors felt uncomfortable about the prospect of having to give uncertain answers, particularly on the timescale of life expectancy.

Very few doctors claimed to have had adequate training in discussing death and the dying process with patients, with many doctors saying that they had to develop these skills ‘on the job’.

As well as exploring perceptions around the availability, accessibility and quality of end of life care, the research also looked at:

• views on and experiences of the doctor-patient relationship and whether this changes when a patient has a terminal illness
• patients’ fears and concerns about the impact of serious/terminal illness and facing death
• views about the potential impact of legalised physician-assisted dying on the doctor-patient relationship
• the professional and emotional impact of involvement in assisted dying upon doctors.

"A top priority for government"

The BMA is calling on the government to prioritise improvements in end of life care.

Dr Wilson explained: "While positive steps forward, such as the new guidelines for the NHS, have been made, it is still essential that care for people who are dying becomes a top priority for governments across the UK.

"Doctors need the time, support and sufficient training necessary for caring for people at their end of life, and patients must be able to access a high quality of end of life care wherever they live, whatever their medical condition."

The National Council for Palliative Care (NCPC) supports the BMA’s call for the government to prioritise end of life care.

Claire Henry, CEO of the NCPC, said: "End of life care has improved in recent years, but much more needs to be done.

"At the government’s request, I chaired a wide-ranging review into end of life care that identified a number of urgent areas for further improvement. I know the government received and appreciated the review, but we are still waiting for a detailed response after almost a year.

"At the moment, too many people do not receive good quality end of life care, and the system is disjointed and inefficient. The way we care for dying people and their families is an important measure of our values as a society. Improving their quality and experience of care should be an urgent priority for the government."

Later this year, the BMA will publish a further report, bringing together responses to the research and subsequent discussions with groups of members and experts in the fields and make a number of recommendations.