A Duty of Care
00:00
Exteriors of King's Palliative Care Department
Interiors – teaching in progress
Guide Voice: The UK’s first academic Palliative Care Department, established at King’s College London, is celebrating its 10th anniversary and it’s still leading development in this relatively new area of medical research, both at home and overseas. So what is Palliative Care and why is it so important?
00:18 SOT: Dr. Richard Harding, Lecturer in Palliative Care, King’s College London - “ Palliative care is concerned with the care of people who are affected by life limiting incurable disease and we’re interested in caring for patients right from the point of diagnosis all the way through to the end of their life and then for their family members into the bereavement phase. And we’re not just interested in the patient, we’re interested in their family members and their loved ones who are supporting them”.
00:38
wide – Palliative Care Consultant Rachel Burman and Specialist Nurse Ian Rudrum discussing patients
c.u. Ian Rudrum
tilt up from hands to Rachel Burman
wide – Burman & Rudrum
wide – Patient Group talking to Professor Higginson & Dr. Harding
GVs – Discussion group in action
Guide Voice: As modern medicine has become more focused on narrow specialty and fighting specific illness it often seems that the patient themselves can become a bystander in their own treatment regime. Palliative care swims against this tide as it seeks to address the wider needs of both the patient and their family and close friends. In this respect palliative care is often seen as the poor relation of medical research as it’s not perceived as curative or making groundbreaking advances in medical science – but its work is increasingly important. There are many illnesses that are degenerative or are accompanied with complex symptoms, such as Multiple Sclerosis, HIV or Cancer and, at a time when, in many societies, populations are living longer, we increasingly need to learn how to manage the long term illnesses that affect aging populations.
01:31 SOT: Professor Irene Higginson, Head of the Department of Palliative Care, King’s College London – “Our work is concerned with people’s symptoms, their problems and in particular in testing and discovering ways to help that. So it might be new treatment for example to help manage breathlessness we’re doing work on or it might be looking at how services work to help people be cared for in their place of choice or it might be looking in more detail at what people want or need”.
01:55
wide - Papers and text books on Palliative Care
c.u. King’s College publication on department policy
c.u. Textbook of Palliative Medicine
GVs Palliative Care teaching in progress
GVs Palliative Care ward in South African Hospice
Guide Voice: In setting up the original department, King’s College London recognised the importance of creating palliative care as an academic discipline. The research they undertake focuses on the total care of patients whose disease is not responsive to curative treatment and has grown out of the hospices that came from the work of Dame Cicely Saunders, increasing in importance as health professionals have come to appreciate the diversity of problems this approach to patients covers. In the world of palliative care the control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. King’s College London has been particularly successful in working with a number of partner organisations around the world to help develop better tools to monitor and improve care for patients and their families. Being a leader in this field of research they’ve been able to make significant contributions.
02:45 SOT: Dr. Liz Gwyther, Chairperson of the Hospice Palliative Care Association of South Africa – “South Africa is probably the place that is leading the field in palliative care in HIV the actual delivery of care… but because of human resource constraints and time constraints we’re not actually researching and writing it up and so the association with Kings came around how do we do effective research, how do we publish our work and Richard has made the outreach to Africa and we’re in a collaborative research project at the moment looking at how palliative care enhances the quality of life of patients in African hospices and we’ve got five sites in Africa, four in South Africa and one in Uganda”.
03:29
Exteriors, St. Luke’s Community Hospice, South Africa
GVs Palliative Care in Hospice
Stills collage of architects’ images of the new Institute of Palliative Care
Guide Voice: Because of the HIV/Aids epidemic it’s in countries like South Africa that it becomes easy to see the value of a discipline that looks outside the immediate medical problems of the individual to consider the requirements of the family and the community as well as the patient’ s wider spiritual and social needs. HIV/Aids impacts on the community as much as the individual and the need for a structured approach to solving the problems of orphaned children and overburdened families gives some idea of how important the research of King’s Palliative Care department has become. Now, as this groundbreaking department approaches its 10th anniversary, plans are coming together for a new Institute of Palliative Care at King’s College London. Named after the founder of the modern Hospice movement, the Cicely Saunders Institute for Palliative Care will take the development of palliative care to new levels, extending current training courses and expanding King’s commitment to innovative research in this field.
04:24 SOT: Professor Higginson – “ Medicine has become much more technological and focussed on bits of people rather than the whole people and it’s been very focussed on cure. If we go back to more earlier times then it was said that medicine would cure some times but relieve often and comfort always and I think palliative care is about rediscovering the relieving and the comforting. We would say that you should always relieve and comfort and obviously you should cure when you can”.
04:53
Additional stills (3) of planned new Institute of Palliative Care
South African patient, husband and care advisor
Guide Voice: In this new institute teaching, research and clinical staff will work alongside each other and dedicated space will provide open access patient and family support, all under the same roof – putting the human element back into the treatment of long-term patients.
05:12 End of cut
Additional Material
05:18 SOT: Dr Harding – “We’ve got a high number of very exciting collaborations globally, we work with a number of partners across Europe, we have a number of partners in the US we’ve been doing multi-centre trials with and I think most excitingly we’ve got a number of partners in developing countries. We’ve been working in Latin America in Cuba and Argentina to help people develop very simple tools to monitor care and improve care for families and we have a very large presence with partners in sub-Saharan Africa which is very exciting in terms of helping capacity building and working with these already existing centres of excellence to help them develop better care”.
05:51 SOT: Professor Higginson – “I hope first of all that it will change the public and professional perception about palliative care. There’s a bit too much of a kind of nihilistic attitude of once you reach a certain stage of illness or you reach a certain age symptoms and problems are inevitable and you can never do anything about them and it’s all very difficult and we just run away. I hope it will change that attitude and we will realise it will be possible to do something”.
06:21 SOT: Dr. Liz Gwyther – “I think that the Cecily Saunders Institute is going to be enormously important in palliative care internationally and I think that for myself, in the new programme at UCT and in the developing programmes that we’v e got throughout Africa that are being supported by the African palliative care association, the Cecily Saunders Institute will add credibility and will assist us in our advocacy with our governments for policy changes that are required and that will also give it the standing that’s required in the medical community”.
06:58
GVs – St Luke’s Community Hospice, South Africa. Patients and Staff
07:16 END
