109 Joint training posts between palliative and emergency/internal medicine: a match made in heaven or a recipe for disaster?

<h3>Introduction</h3> Marie Curie REACT (Responsive Emergency Assessment and Community team) is an innovative acute virtual palliative care ward with Emergency Department in-reach. When developing the service, it was recognised that unique skills would be required, with individuals who have experience and interest in both Palliative Medicine and Emergency or Internal Medicine. Two innovative clinical fellow posts have been developed within REACT for senior trainees. One post is held by an Emergency Medicine trainee (ST3+) and the second post is held by a Higher Specialty trainee (HST) in Palliative and Internal medicine. <h3>Methods</h3> We developed a questionnaire to explore the acceptability of the REACT dual training posts to multi-disciplinary team members working in the Emergency Department. We asked respondents to share their perceptions around the value of the roles and their impact on patient care. <h3>Results</h3> We received 31 responses from medical, nursing and managerial staff. 97% respondents find the training posts are valuable and have a positive impact on patient care in the Emergency Department. 94% feel that the role is helpful for trainee development. Respondents commented particularly on the improvements to patient experience, earlier supported discharges and that dual trainees are able to ‘work effectively on both sides’ and are ‘better able to look at the bigger picture’. <h3>Conclusion</h3> Testing new models of care is essential both for service development and for future-proofing training in order to continue to deliver care which meets the increasingly complex needs of our multi-morbid, ageing population. Clinical fellow posts which provide dual training across Palliative and Emergency/Acute Medicine offer the opportunity to improve delivery of acute holistic palliative care, develop consultants who are confident working across multiple specialties, and may help to contribute to the development of future dual consultant posts.