lucy webb

Manchester Metropolitan University, Nursing, Faculty Member

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researcher: mental health and health psychology.
specialising in: substance use and misuse, recovery, global mental health, secondary data analysis (quant), co-productive methodologies.

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Thomas Lawrence Long

University of Connecticut

Debra Kaysen

Stanford University

Julian Buchanan

Victoria University of Wellington

Teddie Potter

University of Minnesota

Kyle Dyer

King's College London

David Seamon

Kansas State University

Simon Baron-Cohen

University of Cambridge

DAVE HOLMES

University of Ottawa | Université d'Ottawa

Siriphan Sasat

Chulalongkorn University

Hannah Graham

University of Stirling

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Providing holistic end-of-life care for people with a history of problem substance use: a mixed methods cohort study of interdisciplinary service provision and integrated care

BMC palliative care, Apr 1, 2024

Harmful use of illicit drugs and/or alcohol is linked to life-limiting illness and complex health... more Harmful use of illicit drugs and/or alcohol is linked to life-limiting illness and complex health and social care needs, but people who use substances and have complex needs do not receive timely palliative care and fail to achieve quality standards for a good death. They and their families often require support from multiple health and social care services which are shown to be poorly integrated and fail to deliver interdisciplinary care. This study aimed to identify the existing barriers and facilitators within and between services in providing this population with a good death. Using a mixed methods approach of survey, focus groups and semi-structured interviews, we explored the perspectives of practitioner and management staff across a range of health and social disciplines and organisations in one combined authority in a large city in the north west of England. Our findings indicate that practitioners want to provide better care for this client group, but face structural, organisational and professional boundary barriers to delivering integrated and shared care. Differences in philosophy of care, piecemeal commissioning and funding of services, and regulatory frameworks for different services, lead to poor and inequitable access to health and social care services. Ways forward for improving care are suggested as bespoke hostel-based accommodation for palliative care for this client group, and specialist link workers who can transcend professional and organisational boundaries to support coordination of services and support. We conclude that it is no longer adequate to call for more training, better communication and improved joint working. Complex care at the end of life requires creative and cohesive systemic responses that enable multidisciplinary practitioners to provide the care they wish to give and enables individuals using substances to get the respect and quality service they deserve.

lucy webb

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