The Palliative Virtual Ward Programme

16/03/2016

 

Question:

The Hospital Authority (“HA”) launched, in collaboration with some organizations, in 2009 the Home End-of-Life Care Programme (“the Programme”) to enable elderly patients suffering from designated chronic or long-term diseases (e.g. organ failures and cancers) to choose, after being assessed by a doctor, to stay in a suitable home living environment or residential care homes for the elderly (“RCHEs”) and enjoy a peaceful time in the last days of their lives. When those patients are in the very last moments of their life, their family members or the RCHEs concerned may, according to the documents signed and issued by doctors in advance, arrange to send them to the designated accident and emergency departments, but the hospitals will not administer first aid to or perform operations on them and will let them pass away naturally. The doctors will then go through the death certification procedures and issue death certificates. In this connection, will the Government inform this Council if it knows:

(1) the number of participants of the Programme since its launch in 2009, with a breakdown by the diseases from which they suffered;

(2) the public hospitals in which the Programme is currently implemented, and the manpower and resources involved; and

(3) whether HA has considered extending the Programme to all public hospitals and has assessed the additional manpower and resources so required as well as the number of additional persons who may benefit from the Programme; if HA has, of the details; if not, the reasons for that?

Reply:

President,

The Hospital Authority (HA) has all along offered appropriate palliative care services to terminally-ill patients and their families according to the principle of “providing holistic care for patients”. Such services are delivered in an integrated mode through palliative care teams comprising doctors, nurses, medical social workers, clinical psychologists, physiotherapists and occupational therapists. In respect of the question raised by Prof Hon Joseph LEE Kok-long on services provided for terminally-ill patients, my reply is as follows:

(1) and (2)

The Palliative Virtual Ward Programme is a palliative care project offered by the United Christian Hospital (UCH) of the Kowloon East Cluster (KEC). It aims at providing multi-disciplinary support for terminally-ill patients who wish to spend the last days of their life at home. At present, all seven clusters of HA provide comprehensive palliative care services including in-patient service, out-patient service, day care service, home care service and bereavement counselling for terminally-ill patients. While the names of these services may not have the same name as the one used by UCH of KEC (namely the Palliative Virtual Ward Programme), they all provide palliative care services for patients.

HA does not maintain the statistics of palliative care services under individual programmes by clusters. The following table sets out the overall statistics on palliative care services of HA:

Palliative Care Services Attendances in 2014-15#

In-patient service (Number of in-patient/day patient discharge episodes and number of deaths)

8,254
Specialist out-patient service 9,449
Home care service 33,199
Day care service 12,275
Bereavement service 3,034

Note:

# The above figures include only the capacity of hospice service.

Palliative care services of HA are mainly provided by healthcare personnel of the Palliative Care Units (PCUs) and oncology centres. The oncology centres are subsumed under the overall establishment of the oncology departments, and HA does not maintain the statistics on the manpower specifically providing palliative care services. As at 31 December 2015, there were around 200 full-time equivalent nurses serving in the PCUs. And as at 31 December 2015, there were around 400 full-time equivalent nurses serving in the oncology centres.

(3) HA has all along been committed to enhancing palliative care services. Over the years, HA has continued to improve its mode of service and strengthen the provision of multi-disciplinary service so as to alleviate the physical and emotional distress of patients, and improve their quality of life at the end-of-life stage. Since 2010-11, HA has extended the main targets of its palliative care services from mainly cancer patients to patients with end-stage organ failure. The additional resources involved are about $34 million per year. In 2012-13, HA has enhanced the services by clinical psychologists and medical social workers to provide psychosocial service for terminally-ill patients and their family members, and to identify high-risk patients and their family members for early intervention. The additional resources involved are about $12 million per year.

In 2015-16, HA also strengthened the service of the Community Geriatric Assessment Teams to, through the collaboration between multi-disciplinary service teams of the hospitals and the residential care homes for the elderly (RCHEs), better support terminally-ill patients in RCHEs in phases and provide training for staff of RCHEs to improve the quality of care. The additional resources involved are about $7 million per year.

HA will continue to monitor the demand for various healthcare services, and plan and enhance palliative care services having regard to factors like the demographic growth and changes, advances in medical technology and healthcare manpower.

 

 
Last Updated 2016-03-16