Hull York Medical School Professor to lead Yorkshire Cancer Research £1.3 million palliative care improvement programme

Professor Fliss Murtagh Associate Director of the Wolfson Palliative Care Research Centre

Yorkshire Cancer Research is investing £1.3m in a four-year programme of research to improve the quality of palliative care in the region. Professor Fliss Murtagh Associate Director of the University of Hull’s recently established Wolfson Palliative Care Research Centre and Professor of Palliative Medicine at Hull York Medical School, and Professor Michael Bennett at the University of Leeds’ Academic Unit of Palliative Care will lead a multi centre team to advance improvements in palliative care across Yorkshire.

The research will investigate how and when patients access palliative care with a view to introducing new measures to improve how symptoms are formally assessed and monitored, and equip clinical teams with the resources and training to help them address those symptoms.

Nearly 14,000 people die from cancer every year in Yorkshire¹. In the weeks and months before they die, cancer patients often experience breathlessness, fatigue and high levels of pain, alongside other concerns such as practical worries i.e. finance, and the need for family support. Up to 8,000 patients in Yorkshire will experience moderate to severe pain before they die³, with up to 40% reporting uncontrolled pain⁴.

Palliative care aims to make patients as comfortable as possible by managing pain and other distressing symptoms and providing psychological and social support for patients and their family or carers. However, despite a growing need for specialist palliative care support, unlike other areas of medicine, the knowledge base to support the understanding of palliative needs and the development of specialist services is still relatively small. There are also inequalities in access to palliative care across Yorkshire. Previous studies have shown that in Leeds, just 65% of patients with cancer receive palliative care before they die².

This programme will directly improve the health status and symptom experience of Yorkshire patients living with advanced cancer and support their families. It will achieve this by recognising early those who need help, implementing regular assessment and monitoring of symptoms and other concerns, and providing better management of the most challenging symptoms.

The team will work in partnership with local hospices and Clinical Commissioning Groups to develop the programme.

Professor Murtagh says: “At the Wolfson Palliative Care Research Centre and Hull York Medical School we are committed to helping those with life limiting conditions live as well as they can, and, when the time comes giving them control of their symptoms and support at the end of their life.

‘Despite increased understanding of palliative care and improvements to services, unlike other areas of medicine, the knowledge base to support palliative care clinical practice remains small and systems of support are not fully developed to truly help all patients and their families when needed.

‘This programme will enable us to build on existing research undertaken by the University of Hull, Hull York Medical School to deliver a step change in palliative care across Yorkshire– helping clinicians identify and refer patients that require palliative care to ensure they are referred as soon as possible. It will also help Yorkshire hospices deliver palliative care more efficiently by implementing clear assessment and outcome measures. ‘

Professor Fliss Murtagh is a national leader in this field. She holds a National Institute for Health Research (NIHR) Programme Grant which has validated core measures for palliative care across England, developed a framework for assessment of complexity of palliative care needs, and has defined models of palliative care. She has worked with national organisations such as Hospice UK to ensure widespread uptake and training in use of the measures and these will now be available for those with far advanced cancer across Yorkshire, through this bid. Her particular area of focus will be the assessment and monitoring of symptoms and outcomes. Fliss goes on to say:

Currently, almost all routine assessment of the quality of advanced cancer care focus on the structure and process of care, and not on outcomes. While structure and processes are essential for good care, neither guarantee it. It is the improvement in the well-being and health status of those receiving care and their families which really matters – the outcomes. Assessing outcomes enables us to become much closer to what concerns patients and families most; they reflect actual changes in peoples’ health status and wellbeing.

‘The programme will deliver a step change in palliative care across Yorkshire, providing guidance for NHS policy makers, commissioners and providers on improving access to palliative care and ensuring that people with life-limiting illnesses are able to access the care and support they need and deserve. We are extremely grateful to Yorkshire Cancer Research for this vital funding.’

Dr Kathryn Scott, Chief Executive at Yorkshire Cancer Research, said: ‘There is a huge unmet need to improve palliative care in our region. It is essential that patients are comfortable when they are going through the final stages of their experience with cancer, and that their families are supported on this journey.

‘This programme will involve hospices across Yorkshire and thousands of patients with advanced cancer. It will establish Yorkshire as a leading region for the highest possible quality palliative care. We are very proud to be funding this project and would like to thank all our supporters for making this investment possible.’

The project is part of a £3.6m investment by the charity in research that will improve the prevention, diagnosis and treatment of cancer across Yorkshire. It is also one of a number of grants awarded to the University of Hull and Hull York Medical School to help improve the lives of those suffering with life limiting illnesses in the Yorkshire region.

Click here to find out more about the project from Professor Murtagh

References

¹ https://www.cancerdata.nhs.uk/mortality/age_standardised_rates

² Ziegler L, Hill K, Nielly L, Bennett MI, Higginson IJ, Murray SA, Stark D. Identifying psychological distress at key stages of the cancer illness trajectory: A systematic review of self-report measures. Journal of Pain and Symptom Management 2011;41(3):619-36

³ van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, et al. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of Oncology 2007;18(9):1437-49.

⁴ Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009 Aug;20(8):1420-33