title: Extent of palliative care need in the acute hospital setting: a survey of two acute hospitals in the UK.
abstract: BACKGROUND
  In common with international health policy, The End of Life Care Strategy for England has highlighted the delivery of high quality palliative care in the acute hospital setting as an area of priority.
  
  
  OBJECTIVE
  The aim of this study was to explore the extent of palliative care need in the acute hospital setting, and to explore agreement between different sources in the identification of patients with palliative care need.
  
  
  METHODS
  A cross-sectional survey of palliative care need was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Medical and nursing staff were asked to identify patients with palliative care needs. Patients (or consultees) completed assessments of palliative care need.
  
  
  METHODS
  Of a total in-patient population of 1359, complete datasets were collected for 514 patients/consultees.
  
  
  RESULTS
  36.0% of patients were identified as having palliative care needs according to GSF criteria. Medical staff identified 15.5% of patients as having palliative care needs, and nursing staff 17.4% of patients. Patient self-report data indicated that 83.2% of patients meeting GSF criteria had palliative care needs.
  
  
  CONCLUSIONS
  The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need. Consensus between medical staff, nursing staff and the GSF was poor regarding the identification of patients with palliative care needs. This has significant implications for patient care, and draws into question the utility of the GSF in the hospital setting.
authors.affiliation: University of Sheffield, School of Health and Related Research (ScHARR), Sheffield, UK. c.gardiner@sheffield.ac.uk
authors.forename: Clare
authors.initials: C
authors.lastname: Gardiner
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
authors.forename: Christine
authors.initials: C
authors.lastname: Ingleton
authors.forename: Jane
authors.initials: J
authors.lastname: Seymour
authors.forename: Mark
authors.initials: M
authors.lastname: Cobb
authors.forename: Bill
authors.initials: B
authors.lastname: Noble
authors.forename: Mike
authors.initials: M
authors.lastname: Bennett
authors.forename: Tony
authors.initials: T
authors.lastname: Ryan
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010166:Palliative Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom