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End of Life care

If MRC grade 5, or patient has had 3 or more admissions for COPD within the previous 12 months, ensure inclusion in Gold Standard register.

A planned approach to care should include registering the patient on the practice Gold Standard supportive care register, and recognising when hospice directed care may be more appropriate than an acute hospital admission.

The information below is all part of the ePCS, which can be used for the collation of a patient's palliative care information, even if not used for data transfer to OOH or acute receiving services.

Part of discussion with the patient should be to make them aware of the prognosis. Record in the template that the issue has been discussed with your patient, and use free text extension.

Please record preferred place of care for next exacerbation in the relevant drop-down box.

Ensure your patient is included in the Practice Palliative Care Register for QOF, and Palliative Care LES if appropriate

Opiates may be appropriate in patents with severe COPD for the palliation of breathlessness or cough unresponsive to other medical therapy, including oxygen if hypoxic. Benzodiazepines may help associated anxiety or panic.