Return of the Mac

“Return of The Mac.”

Patients and staff from the Macmillan Unit have returned home to Christchurch after having been temporarily relocated to the Royal Bournemouth Hospital (RBH).

To allow for the increased need for high-quality palliative and end-of-life care due to the Covid-19 pandemic, the patients and staff normally located at the Macmillan Unit based at Christchurch Hospital were temporarily relocated to the Derwent in April, a self-contained unit at RBH.

The move allowed staff from the Macmillan Unit to work closely with their nursing and therapy colleagues at RBH, and also enabled other staff to gain valuable experience working in palliative care.

Laura Cutress, a staff nurse usually based in sexual health, joined the team on the Derwent. She said: “It has been very different working in palliative care, but I really enjoyed my time on the unit. It’s busy, but in a different way to running clinics. My colleagues from palliative care are amazing – super friendly and incredibly welcoming.

“I feel privileged to have spent time with some patients in their last days and to have supported such a fantastic team in delivering the incredible person centered care they give. It’s been very rewarding. Long term I feel this has been an opportunity to increase my knowledge and enhance my communication skills.”

After several weeks working with the teams at Bournemouth, the staff and patients began the move back to Christchurch Hospital on 21 May, where building work has been completed to ensure the Unit can be used safely under current infection control measures.

Dr Megan Howarth, palliative care consultant, said: “I am so proud of the resilience the teams have shown during this period of change. Their commitment to providing outstanding care to our patients has not wavered, even in challenging times. We have learnt that it doesn’t matter where we’re based, we can still provide the same high quality of care as long as our focus is on our patients and what matters to them. We are incredibly grateful to everyone who has supported us, and particularly to the Derwent Team, who we have loved working with.”

The Macmillan Unit is part funded by local charity, Macmillan Caring Locally, who continued to support staff and patients throughout the relocation.

Neal Williams, Trust Secretary for Macmillan Caring Locally, said: “We are so proud of our Macmillan Team and Derwent colleagues who have continued to provide the best possible care for our patients and support for their families under very challenging circumstances. We were delighted to welcome our patients and staff back to the Macmillan Unit.”


List of pharmacies 

 Pharmacy name and address

Phone Number

100 hour pharmacy

 Locality

Asda Pharmacy

St Pauls Road, Bournemouth,BH8 8DL

01202 298900

Yes

Bournemouth East

Castle Lane Pharmacy
482 Castle Lane West Bournemouth, BH8 9UD

01202 772110

Yes

Bournemouth West

Ferndown Pharmacy
487 Ringwood Road, Ferndown, BH22 9AG

01202 892666

Yes

East Dorset

Tesco Extra Pharmacy
Yarrow Road, Mannings Heath Poole, BH12 4NX

01202 457447 or 01202 367447

Yes

Parkstone

Asda Pharmacy
West Quay Road, Poole, BH15 1JQ

01202 207000

Yes

Poole Central

Equipment – www.redcross.org.uk Is useful for wheelchairs and other equipment

Guide for people nearing end stage of life : https://intranet.rbch.nhs.uk/uploads/palliative/documents/What-to-Expect.pdf

Brief Drugs List for GPs

 

Pain/breathlessness:

Morphine sulphate 2.5-5mg SC PRN (10mg in 1ml injection)

(alternative if taking PO or eGFR<30 – Oxycodone 1 – 2.5mg SC PRN (10mg in 1ml injection))

[Please take background opioid into account when prescribing doses for anticipatories]

Anxiety/distress:

Midazolam 2.5-5mg SC PRN (10mg in 2ml injection)

Secretions:

Glycopyrronium 200mcg SC PRN (600mcg in 3ml injection)

(alternative for secretions: Hyoscine Butylbromide 20mg/ml injection)

Nausea :

Levomepromazine 6.25mg SC PRN (25mg in 1ml injection)

(alternative for nausea: Haloperidol 1.5mg SC PRN (5mg in 1ml injection)

Water for injection

Dexamethasone 3.3mg SC OD-BD (equivalent to 4mg PO) if risk of steroid withdrawal/Addisons during terminal phase.

Day/Time Example Timetable
Monday - AM

9am MMU Ward Hand over; 9:30am Tour of MMU

10m Consultant Ward Round, MMU

Monday - PM

12pm Ward Nurses - syringe driver administration (treatment room)

1:30 Nursing Handover – MMU (ward office)

MMU – Admission Assessment(s) with ward doctor

Tuesday - AM

9am Ward Hand over

9:20am Referrals Meeting on MMU

10am Community visiting with Specialist Nurse

Tuesday - PM

12:30 Journal Club – MMU (doctors office)

2pm Introduction to Patient and Family Support Team

3pm Introduction to Welfare and benefits Advisor

Wednesday - AM

9am Ward Hand over

9:20am Referrals Meeting on MMU

10am Consultant ward round - MMU

Wednesday - PM

2pm Doctor/Nurse Home Visit with Specialty Doctor

Thursday - AM

9:15am Multi-Disciplinary Team Meeting on MMU

Thursday - PM

2pm Introduction to Palliative Rehabilitation with Physiotherapist

3pm Introduction to Complex Discharge Planning in terminal illness

Friday - AM

Hospital Palliative Care Team Ward Visits

Friday - PM

2pm Introduction to Personalised Care Plan for the Last Days of Life with End of Life Care Nurse

4pm Debrief / sign off