Wanted: Help through the jungle of hospital care

December 11, 2003

The compassionate side of patient care in hospital-or rather the lack of it-is discussed in this week's editorial. The Lancet is calling for a substantial increase in specialist liaison staff to bridge the gap between medical intervention and the often unmet emotional needs of patients and carers.

The editorial cites a correspondence letter (p 2022) in this week's issue which states: "Experiencing the world of the inpatient was for us, the inpatient family, like landing on Mars", writes a mother describing her and her husband's perception of the 2-year journey of her young, chronically ill daughter [Michaela] through the modern medical system-a journey that ended tragically in death.

Commenting on this, the editorial states: 'Success of new medical interventions is measured by the numbers of patients who survive or the numbers of days those patients stay in hospital. Only rarely are quality of life or the emotional wellbeing of children, let alone their immediate family, in hospital or after discharge, taken into account.

Provision of liaison staff to assist patients and carers through traumatic procedures-already introduced in specialties such as oncology and transplant medicine-is viewed by The Lancet as crucial if the status quo is to change.

The editorial concludes: 'In its 10-year plan for the National Health Service, published in 2000, the UK Government recognised the need to make its health-care system more patient-centred and family-friendly. It drew up a plan for a Patient Advocacy and Liaison Service (PALS) in every Trust...Over 500 Trusts now have these services; on average they employ 2•5 full-time staff who provide support, education, and an open ear for any concerns and problems. But this scheme is only the first step to the wider use of patient liaison personnel within a multidisciplinary team. 2-3 people for a whole Trust are simply inadequate. Every single ward that has responsibility for seriously ill patients-children and adults-should have at least two patient or family liaison officers to assist families. With this kind of support, perhaps stories like Michaela's and her parents' will belong to the dark ages of medicine-a time in which, shamefully, it still seems we are living.'


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