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MPs to begin 'broad' inquiry into palliative and end of life care


The Commons’ health select committee is today launching its latest inquiry into end of life care, in the wake of the controversy over the now withdrawn Liverpool Care Pathway.

In June the Department of Health announced a new approach to end of life care in England, focusing on achieving five Priorities of Care that should be applied in all care settings.

While noting the new guidance, the committee said it had decided to take a “broader look” at the issue of palliative and end of life care. 

The inquiry will examine palliative and end of life care for adults, including the frail elderly, and children and young people.

Health select committee

Sarah Wollaston

The committee said it would examine the way that health and social care services, and the voluntary and community sector, supported people likely to die within 12 months, what opportunities existed for better integration and for improving care, and the experience of those caring for people at the end of life. 

This will include investigating what changes may be needed in staff numbers and training to enable generalist healthcare staff to improve their skills and confidence in supporting people at the end of life.

The committee, which is chaired by Tory MP for Totnes and former GP Dr Sarah Wollaston, added that it would also review the definitions of, and distinctions between, “palliative” and “end of life” care in order to examine how to provide more effective targeting of resources and management of interventions.

Issues it plans to cover include:

  • The extent to which palliative and end of life care services are provided by acute, social care, community and voluntary services or charities, how this balance has changed over time, and the quality and experience of end of life care in different settings
  • The impact on delivery of end of life care in hospital following the withdrawal of the Liverpool Care Pathway
  • The reasons why so many people die in hospital when the majority of people say that that they wish to be cared for and die at home or in a hospice
  • The impact of geography and demographic characteristics on access to, and quality of, 24/7 specialist palliative and end of life care
  • The competence and capacity of the workforce. What changes may be needed in staff numbers, skills and training to enable generalist health and social care staff to improve their skills and confidence in supporting people at the end of life?
  • Funding mechanisms for palliative and end of life care. 
  • Whether the right services are being commissioned to provide quality end of life care in acute and community settings, so that people are getting the right care, in the right place at the right time
  • How easily can patients withdraw from active treatment if that is their preference
  • The experience of and support for those who are caring for people at the end of life, including the availability and quality of bereavement services
  • What research is currently being carried out into palliative and end of life care?

Written evidence must be submitted to the committee via its website by noon on 15 December.


Readers' comments (4)

  • michael stone

    Thanks NT, being dozy I would probably not have spotted this one.

    It is almost certain, that I will be submitting something.

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  • (United State, HMO home nurse, client's home), Elderly friend in excellent physical health, but with very early AD.
    More or less verbatim conversation, with nurse regarding care options.

    Feeding tube -YES if it looks like it might help. Give it a try for a few weeks to see if it helps, but not if it's going to be permanent.

    Heroic measures -- NO, not if there is no chance I will ever recover

    CPR - YES.
    Mostpeople decide against having CPR. Are you sure you want it?" YES.
    "But it will likely be very painful. They usually break a lot of your ribs if they do CPR, are you positive want it?" YES.
    "it probably won't work - are you sure that's what you want? Most people never really recover, and it hurts a lot. Many who do have CPR regret it later because of the pain of the broken ribs -- are you positive?" YES

    "what if they come in and you are cold and unresponsive, are you sure you want them to do CPR even then?" YES
    even if you are unresponsive? YES

    Finally, she gives up..."Well, we can always come back to this decision later..."

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  • isn't end of life care between the the patients and the healthcare experts they have been entrusted to? why all this sudden political (non-expert) interference?

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  • michael stone

    Anonymous | 9-Nov-2014 8:55 am

    Because 'the experts' 'as a system' are too often getting it wrong: for example, sometimes a patient can explain to his family and GP that he wants to die at home, but still ends up being rushed into hospital 'as he is dying' because of the way that 999 Services 'think and behave'.

    Although the MPs also want ideas about how to improve things such as 'joined up behaviour' and how to get the most out of the resouces which are available.

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