Case Study - The Distress Thermometer, Toolkit For Palliative & Holistic Care

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distress thermometerThe role of the GP is continually expanding, increasing the requirement for palliative and holistic care. When patients are diagnosed with cancer or serious disease, we are required to perform an annual review. Part of the review should include a holistic needs assessment or a discussion about the patient and their carer(s) emotional wellbeing. The definition of distress is, “anything which impacts negatively upon your life and stops you from doing anything you enjoyed before your diagnosis”

Finding the best way to approach this can be challenging. The physical challenges presented are often the most obvious and are the focus of any treatment. However, we should feel well-placed to advise people when dealing with other difficulties such as the psychological, spiritual, social and practical issues.

Having a serious illness can impact on many aspects of a person's life. For many reasons, we know that it can be difficult for GPs and the patient to discuss the broad range of challenges that some diseases present.

Recently I was shown the Hillingdon Oncology and Palliative care team’s brochure on ‘The Distress Thermometer’. In short it is a tool which can help breach the difficulty of opening a conversation between doctor and patient about the wider range of ‘distress’ issues. It also advises on the services and resources that may be helpful in addressing them.

There are many ways to use the Distress Thermometer as it allows a whole range of concerns to be explored. It has certainly enriched my consultations and provided opportunities for my patients to reflect, opening up a discussion they may not have approached before. In this instance I and the primary care team can be more supportive and 'aware', signposting them to organisations and useful local services that may not have been previously apparent to refer to.

The Distress Thermometer has been written for a London CCG however many of the links and support services mentioned provide nationwide support. Filling in or finding out the relevant local information would only take a few minutes (the beauty of the internet!) and can prove an efficient and thorough method of providing over and above the necessary care.

Reference: Distress Thermometer booklet produced by the Hillingdon Oncology & Palliative Care Team

Weblink:  http://www.nwlcn.nhs.uk/Downloads/Specialist-and-palliative-care/The%20Distress%20Thermometer%20leaflet%20draft.pdf

Dr. Ishani Patel
MBBS BSc MRCGP DCH DRCOG
General Practitioner
E-learning CPD Fellow, RCGP
Associate GP, Cancer Commissioning Team – North West & South London
Advisory Committee on Cervical Screening (ACCS), Public Health England
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