alexa Pediatric Oncology Palliative Care

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Pediatric Oncology Palliative Care

Providing palliative care to adults is seen as an important component of general practitioners’ (GP’s) practice as, although palliative medicine is recognized as an established specialty, it is unlikely that all patients requiring palliative care will be managed by a specialist [1]. “Palliative care” is used here to describe the holistic multi-professional care given to children and their families, and “palliative medicine” the medical specialty of doctors working solely with patients with life-limiting conditions. Pediatric palliative medicine (PPM) is less well established than adult palliative medicine (only being recognized as a subspecialty for doctors in 2009 [2]) and providing palliative care to children often poses challenges to GPs [3]. The challenges can be attributed in part to the infrequency of child deaths in the community but may also be influenced by the lack of pediatric training UK GPs undertake (only 40-50% of GPs complete a pediatric placement during training [4]). Childhood cancers, although rare, cause the largest numbers of deaths by disease in children aged 1-19 years [5] with more than 400 children a year dying from cancer in the UK [6]. The incidence of childhood cancer deaths and infancy of PPM as a specialty, coupled with parental preference for their child to die within the family home [6] highlight the importance of the GPs role in this highly specialized area of clinical practice. Although nationally in the UK there is a recognized lack of standardization in children’s palliative care provision [7] exemplars of specialist teams for defined disease groups exist, such as within children’s cancer care [6]. Here there is a defined model for providing palliative care where pediatric oncology outreach nurse specialists (POONS) take prominence in coordinating care [6]. POONS work between primary, secondary and tertiary care providing specialist advice (such as symptom management) and support to families and health professionals. The GP however has a unique role as the only health professional that has long-term involvement with the family; their role transcending palliative care incorporating bereavement support and on-going medical care for family members.

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