I am an infectious diseases and microbiology consultant at Barts Health NHS Trust with interest in endovascular and respiratory infection, and the OPAT consultant lead at one of our hospitals, St Bartholomew's Hospital, a tertiary specialist centre. Our relatively new OPAT service treats patients with complex endovascular infections, complex respiratory infections and infections in the haematology-oncology population. Given the nature of the population we serve, we occasionally accept patients with chronic, incurable infections, after a careful individualised assessment, for long courses of intravenous antibiotic therapy at home. This involves sometimes treating patients in an active palliative care pathway, but more often it refers to patients on very long courses of antibiotics for incurable infections that would otherwise require repeated admissions to hospital or long hospital stays. We call this palliative OPAT.

These conditions, patients and families present with different treatment, monitoring and ethical challenges to the general OPAT population. Trust and co-ordination between the OPAT team, the patients, relatives and carers, and the main treating teams are essential to build a successful working team that must be truly multidisciplinary and patient centered. We all learn together and patients teach us valuable lessons and help us to grow and improve, and it is extremely rewarding seeing how we can contribute to make patients and relatives lives a little better. Today we will be hearing what difference palliative OPAT can make from a patient's perspective.