PPF51 Including palliative care clinical nurse specialists at oncology MDTs: facilitating earlier referral to specialist palliative care

<h3>Background</h3> Early palliative care improves quality of life for cancer patients. Specialist input aids symptom control, communication about prognosis and preferences, and aligns care with patient goals. It reduces unnecessary admissions or procedures and increases patient and caregiver satisfaction (1-3). Integration with oncology is recommended for all advanced cancer patients but often occurs late (4-7). Oncology multi-disciplinary team meetings (MDTs) are one opportunity for earlier palliative care intervention. <h3>Aim</h3> This project pilots the inclusion of Palliative Care Clinical Nurse Specialist (CNS) in oncology MDTs to facilitate early identification of advanced cancer patients and promote timely involvement of palliative care. <h3>Method</h3> Between June 2025 and March 2026, the Specialist Palliative Care team (SPCT) are attending weekly MDTs for cancer of unknown origin, colorectal, pancreatic, upper gastro-intestinal and lung. CNSs offer specialist symptom management advice, facilitate care discussions, offer education and advocate for integrated care. Data is collected about the number of patients with palliative care needs, their current or previous involvement with SPCT and onward referrals or input. <h3>Results</h3> To date the team have attend 64 oncology MDTs, discussing 1015 patients, of whom 143 had an incurable metastatic cancer diagnosis: colorectal, 50 (15%); pancreatic, 9 (17.3%); upper GI, 32(15.6%); lung, 45 (11.9%). Twenty patients (13.9%) across all diagnostic groups were already known to SPCT. Seven patients (4.8%) were newly identified and referred to inpatient or community SPCT following the MDT. Remaining patients were being considered for further investigation, treatment or were identified as having no specialist needs. <h3>Conclusions</h3> SPCT CNS attendance at oncology MDTs provides an opportunity to give prompt clinical advice, communicate insight into patients’ holistic needs and expedite specialist palliative care input. This is one mechanism to improve access to specialist palliative care for people living with advanced cancer. Further research is ongoing to evaluate outcome measures and other performance indicators, such as preferred place of death and advance care planning, in this patient group.