BackgroundThe Outcome Assessment and Complexity Collaborative (OACC) created a standardised, validated suite of outcome measures for use in palliative care. The key features are the holistic approach, with involvement of the Multidisciplinary Team (MDT) and the patients/families themselves. Our hospice currently uses three outcome measures: the Integrated Palliative care Outcome Scale (iPOS), the Australia-modified Karnofsky Performance Status (AKPS) and Phase of Illness. All three outcome measures are discussed in the weekly multidisciplinary team meetings, both in the in-patient unit (IPU) and the day hospice.AimThe use of outcome measures was first piloted in the IPU and day hospice in 2012, but there has been no recent audit of their use. Anecdotally the outcome measures are consistently available for review at the MDT meeting but there is not always an available explanation when the iPOS is incomplete. This audit aims to quantify the compliance.MethodsThis is a retrospective audit, aiming to capture all patients in a one month period who were admitted to the IPU or who attended the day hospice for assessment. The standards (all with 100% targets) will include:iPOS offered to patients on admission (IPU) or at first assessment (day hospice)iPOS offered weekly thereafter – Reason for non-compliance documented when iPOS not completedAKPS and Phase of Illness discussed weekly at the MDT meeting (both IPU and day hospice).A secondary project will involve documenting baseline scores and changes in scores during admission or time attending the day hospice.ResultsFull results awaited.ConclusionThis project encompasses an audit to assess compliance and a secondary project to explore changes in outcome measures during an episode of care. We hope this information will help to further promote the use of outcome measures in clinical practice throughout the hospice.

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has an honorary senior lectureship, and one has a clinical consultant post. In comparison, up to April 2014, 76% of CLs in all specialties continued in an academic post. PACTs members have also published over 100 research papers since 2009. Discussion A national peer support network for IATs in palliative medicine is particularly important because the small number of posts limits local support. PACTs works well, and is considered helpful by members. Career progression for PACTs members compares favourably to national averages for IATs. This peer support model could be used elsewhere to support clinical academic training in palliative medicine.

Introduction Long-term abdominal drains (LTADs) prevent ascites build-up, improve quality of life (QOL) and reduce hospital admissions for patients with refractory ascites. In NHS Grampian patients with decompensated end-stage liver disease (ESLD) not suitable for transplant or TIPSS are offered an informed choice between repeated large-volume paracentesis (LVP) and LTAD. In NHSG, LTADs are inserted by Palliative Medicine physicians. Methods • Retrospective data collection/analysis for ESLD patients who underwent LTAD insertion in NHSG between 2020-2022. Results 23 ESLD patients underwent LTAD insertion. 8 further patients were referred for LTAD but died before insertion. In the 3 months prior to LTAD, patients had an average of 3 admissions for LVP (range 1-6). The mean number of days between LTAD insertion and death was 59 (range 7-320). LTAD insertion prevented a mean of 2 further admissions for LVP per patient (range 0-10). 74% had no complications and either had LTAD in until death, or are still alive. 2 patients (9%) had infections; 1 resolved with antibiotics, 1 required drain removal. 4 patients (15%) accidentally had their LTADs pulled out or damaged. Prior to LTAD, 65% of patients had no evidence of advance care planning (ACP). Post-LTAD, 74% of patients had an improvement in documented ACP. Only 17% of patients died in an acute hospital, the majority dying at home or in a palliative care unit or community hospital. Conclusion The majority of patients had no complications from LTAD and it remained in situ until death, reducing hospital admissions and allowing more time at home. 74% had improvement in ACP documentation after LTAD insertion, and only 17% of patients died in an acute hospital, compared to the national figure of 73%. Having Palliative Medicine physicians running the LTAD service allows early introduction of Palliative Care for decompensated ESLD patients and offers the opportunity for holistic assessment and ACP discussions.