I had the chance to do my observation week at the recently built Marie Curie Cancer Centre in Solihull near Birmingham/ West Midlands in the United Kingdom. There were various reasons for carrying out the observation week there. I was interested in learning more about the English healthcare system, especially with regard to the structure of palliative care in the UK. I also wanted to gather information for the personal project that I am conducting as part of the EUPCA Leadership Course. My project is concerned with the implementation of advance care planning in German nursing homes. Furthermore, I wanted to get insight into the in-hospice and outpatient services implemented by Marie Curie Cancer Centre and the Macmillan nurses.
So I travelled to Birmingham for what transpired to be a very rainy week in January 2014. I received wonderful support from the local consultant of palliative care at the Marie Curie Cancer Centre and from the whole staff and the week was organised very well. I observed the work and daily activities at the Centre, spent one day at the in-hospice and talked with the local social workers. On another day I attended different multidisciplinary team rounds both for the out-patient services and the hospital patients. On a further two days I shadowed Macmillan nurses in the area of Solihull and Marie Curie Cancer Centre nurses in the wider area of Birmingham.
The hospice structure is very interesting; it is quite similar to that of the German palliative care wards. The structure of palliative care in the English healthcare system is driven by the motivation, not to let a patient slip through the system. Every patient is treated by their general physician; he/ she takes control of the whole process, gets support from local carers, district nurses and social workers. If the patient requires more help, they take a look at the package of care and organise the help which is needed. This structure makes it possible to have palliative care as a working system of early integration, something very motivating for me because it is not known in Germany in this way. After visiting several nursing homes, I also got the chance to learn more about advance care planning in the UK by talking to several general physicians. Overall, the Marie Curie Cancer Centre is the central place for all activities in palliative care in the Solihull area. They have a 24 bed
hospice, a day-hospice with 10 spaces, the out-patient service (by Macmillan and Marie Curie nurses), and a well organised volunteer service among other facilities. I am very impressed with the whole structure of palliative care in the English healthcare system and the naturalness of handling early integration in palliative care.
Over the course of the week I learnt a lot about advance care planning, especially in nursing homes. With this newly acquired knowledge, I now have the chance to develop my project successfully over the next months while being part of the EUPCA Leadership Course. Besides this, I met many very interesting people who, like myself, are highly motivated to work in the field of palliative care. This is the aspect which makes the EUPCA and this observation week so important. Meeting people from different European countries and from various professions and speaking the same language of palliative care allows us to share experiences and gain knowledge and competencies. This provides us with the strength and resources to develop palliative care in our own structures.
I want to thank the Robert Bosch Stiftung for giving me that chance.
Author: Boris Knopf, member of the PalliativTeam Frankfurt gGmbH