116 Collaborative working to support patients who use alcohol and/or drugs to access appropriate palliative and end-of-life care

<h3>Introduction</h3> Patients who use alcohol and/or drugs often have difficulty accessing appropriate support regarding palliative and end-of-life care issues. They are less likely to seek primary care support, more likely to access emergency healthcare services,¹ and lack trust in healthcare providers.² Healthcare professionals may lack knowledge about managing their complex3. Improving organisational relationships and collaborating with other services can improve palliative and end-of-life care for these patients.^{1 3 4} <h3>Method</h3> South East &amp; Central Northumberland community palliative care team and Northumberland recovery programme (supporting people with drug and alcohol problems) developed a joint initiative to support patients with a palliative diagnosis and use alcohol/drugs. A monthly MDT has been developed where existing and new patients are discussed with ongoing community support provided, as required. <h3>Results</h3> The joint initiative started in April 2023. Four patients have been supported, with a fifth patient declining input. Of the 4 patients: Mean age 50 (41 – 74) All male Two used drugs and alcohol; two used alcohol Diagnosis: end stage cirrhosis³; metastatic lung cancer¹ 2 died; 2 alive. Referred to palliative care: 7 &amp; 9 months before death; 3 &amp; 10 months ago for those still alive Of the 2 patients who died: Preferred place of death: 1st choice achieved¹; 2nd choice achieved¹ <h3>Conclusions</h3> We recognise that the number of patients is small, but this alone can make it hard for professionals to maintain expertise or know who to contact for support. Both teams recognised that they were struggling to support the needs of patient with a palliative diagnosis and who use alcohol and/or drugs. Collaborative working has improved organisational relationships and support for professionals enabling patients and their carers to hopefully receive better palliative and end-of-life care. <h3>References</h3> Shulman C, Hudson BF, Low J, <i>et al</i>. End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care. <i>Palliative Medicine</i> 2018;<b>32</b>(1):36–45. doi:10.1177/0269216317717101. McNeil R, Guirguis-Younger M. Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: Perceptions of health and social services professionals. <i>Palliative Medicine</i> 2012;<b>26</b>(4):350–359. doi:10.1177/0269216311402713. Ebenau A, Dijkstra B, Ter Huurne C, Hasselaar J, Vissers K, and Groot M. Palliative care for patients with substance use disorder and multiple problems: a qualitative study on experiences of healthcare professionals, volunteers and experts-by-experience. <i>BMC Palliative Care</i> 2020;<b>19</b>(1):8. https://doi.org/10.1186/s12904-019-0502-x. Cook O, Doran J, Crosbie K, Sweeney P, Millard I, O’Connor M. Palliative care needs and models of care for people who use drugs and/or alcohol: A mixed methods systematic review. <i>Palliative Medicine</i> 2022;<b>36</b>(2):292–304. doi:10.1177/02692163211061994.