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Government commits to ‘high quality’ end of life care by 2020

  • 48 Comments

NHS and care professionals will be expected to “reflect” six new commitments in their work surrounding end of life care, the government has announced.

Made in response to an independent review of end of life care, they include having “honest discussions” with patients who are dying, better care planning and more “informed” choices on care.

The Department of Health set out the six commitments yesterday, saying they were intended to end “variation in end of life care across the health system by 2020”. In full, the commitments are:

  • honest discussions between care professionals and dying people
  • dying people making informed choices about their care
  • personalised care plans for all
  • the discussion of personalised care plans with care professionals
  • the involvement of family and carers in dying people’s care
  • a main contact so dying people know who to contact at any time of day

New measures will be developed to ensure local health and care leaders are meeting the standards expected of them, added the government.

It said plans were already underway to ensure experts could provide specialist support on end of life care by acting as a first point of contact for anyone who needed them, as part of urgent and emergency care hubs currently being developed in all local areas.

“Every person nearing the end of their life should expect a good death”

Ben Gummer

The experts would be available 24 hours a day, seven days a week to help with symptom control or deteriorating conditions late at night or at the weekend, as well as clinicians who had questions or needed additional support.

In addition, there will be a “focus” on improving the training for clinicians, including a national plan aimed at sharing best practice among NHS staff, said the DH.

Pilots in Southend and Airedale will be launched to trial new ways to support clinicians to initiate meaningful conversations with dying people about serious illnesses.

Department of Health

DH moves to quicken FtP process and end midwife supervision

Ben Gummer

A potential new role, a care coordinator, will also be tested with the aim of helping patients have more choice and control at end of life.

Meanwhile, innovative community care pilots, including 24/7 specialised nursing services for end of life care, will be tested in a number of areas.

Announcing the measures, health minister Ben Gummer said: “Our commitment is that every person nearing the end of their life should expect a good death: attentive, dignified and compassionate care.

“To do this, we will address poor care where it exists and accelerate improvement across the health and social care system in England,” he said.

The announcement by the DH was made in response to report – called What’s important to me: A review of Choice in End of Life Care – which was published in February 2015.

Published by an independent board chaired by Claire Henry, chief executive of the National Council for Palliative Care, it offered a blueprint for how greater choice in end of life could be achieved.

“I’m pleased by the overall vision set out in the government response”

Claire Henry

Among its recommendations were that each patient should be offered a care coordinator who would be their “first point of contact”, as well as a named senior clinician who would have overall responsibility for their care and their preferences.

In addition, it said there needed to be “more honest and open” communication about end of life issues, with better support for healthcare professionals and increased awareness among the public.

It also called for a new right in the NHS Constitution for everyone to be offered choice in the end of life care, and for these choices and preferences to be recorded in a personal plan of care.

Responding to the DH, Ms Henry said: “I’m pleased by the overall vision set out in the government response. They have clearly acknowledged our report, and taken its recommendations seriously.

“It will be vital that we continue to work with the government to ensure all these commitments are realised as part of all future care delivery,” she said.

However, another report, also published this week, warned that an overload of policy recommendations is making it harder for nurses and other health professionals in England to deliver quality end of life care.

Written by Sheffield Hallam University, the State of the Nations report looked at policy on terminal illness in all four UK nations. It found 76 different government publications relating to the subject had been published in England since 2004.

Meanwhile, draft guidance from the National Institute for Health and Care Excellence has outlined what the best palliative care for children looks like.

The draft emphasises the need for infants, children and young people to be treated as individuals and highlights the importance of children and their families being involved in decisions about care.

  • 48 Comments

Readers' comments (48)

  • Dear Michael. I enjoy coming here to read insightful comments from other nurses and learning from their different viewpoints, and yours, if you have them, and they're relevant. However, you are turning this forum into some sort of outlet for your own self interest and I honestly think this upsets people who feel this is an unwelcome obstacle in our ability to engage effectively with each other. Please can you consider this when posting in the future.

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  • Michel, are you taking over the whole site or just monopolising certain pages? It should be quite clear by now what is thought of your constant interference. When you have finished perhaps we can have our once highly esteemed nursing journal back.

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  • Michael stone. Think about the meaning of the nouns 'user' and 'name', you can use a good quality dictionary of English to help you if you find it difficult. you can then look up the term 'username' and its uses on the Internet. There you will learn that as a 'username' you can use your own name, make one up yourself or use an online generator to create one for you. to log in to most sites you need one of these or an e-mail address. once logged in, you can chose to post anonymously if the option is available, as it is here and as a number of professionals do, and their right has to be respected. It is entirely your own responsibility to familiarise yourself with all the website rules and as you are not the only poster permitted to post here we request that you do so.

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  • michael stone

    12 JULY, 2016 6:31 PM & 12 JULY, 2016 6:31 PM

    This NT article was about end-of-life guidance, and it is the correctness or otherwise of EoL guidance which is my main interest, and my main reason for attempting to engage nurses, doctors and others (social care staff and police, for example) in discussion of them. Naturally, an article such as this one, will attract my attention.

    My other main reason for trying to get that lay-professional debate started, is that things frequently look different from different perspectives, so 'the issues that seem the more important' often look different to the professionals and the service users: the consequence is that when left largely to their own devices, professionals 'create biased guidance'.

    13 JULY, 2016 9:49 AM

    I feel certain that NT allows people to post with their real name, or with a name they have made up to post under [which I was referring to as a 'username'], or as Anonymous. It is comparatively simple to link together a series of posts which are tagged as 'Fred Jones' or as 'Nice Nurse', but much more difficult, or even impossible, to do the same if people decide to post under Anonymous. The point is both clear and irrefutable - playing verbal games around the word 'username' is out-of-place, in connection with that issue.

    And I really do wish that NT would desist from removing posts which are having a go at me, without leaving a place marker - and even better, as I've said before, would be for NT to leave the posts where they are.

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  • Michael, for the umpteenth time it is not up to you to dictate to the NT, or to other posters commenting within the community rules, how to comment here. If you wish to start a lay discussion please go to the appropriate website for that purpose. As has been pointed out to you on many occasions this is a professional journal for nurses which your comments are dominating to the cost of any sort of reasoned and purposeful discussion between professionals.

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  • One problem with this is, even when one endeavours to exchange views with colleagues, it cannot take place without the persistent intervention of M. stone, desperate to join in and attempts to show he knows best but in the absence of any professional experience. This only serves to block any further meaningful discussion and is a considerable waste of time and effort.

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  • michael stone

    12 JULY, 2016 10:13 PM & 13 JULY, 2016 10:31 AM

    I'm wondering, if you have read the DH piece which this NT article was discussing ?

    On page 13 of the DH document you will find:

    'We will continue to work closely with our voluntary sector partners including on specific projects to improve end of life care in hospital and out-of-hospital settings, promote a national conversation about death and dying ..'

    That says the DH 'will promote a national conversation about death and dying'.

    I've asked the people who are tasked with doing that, to confirm that they will be trying to promote a national conversation between everyone - patients, nurses, current and bereaved family carers, doctors, police officers, 999 paramedics and EVERYONE IN THE NATION [who wishes to contribute to that conversation] - and how they will achieve that object of 'a single conversation about death and dying inclusive of all who wish to contribute'.

    It appears that some nurses - ' If you wish to start a lay discussion please go to the appropriate website for that purpose' 'when one endeavours to exchange views with colleagues' etc - do not agree with the DH and me (and with most EoL experts) that we ALL need to DISCUSS EoL TOGETHER !

    Which is rather the point - 'living in silos' doesn't help, when discussing EoL !

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  • Michael stone. Please take you thoughts to the appropriate platform for that purpose.

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  • care planning needs to be incorporated when people are well, its needs to be reviewable, involve others at the request of the indvidual .It should stand as a seperate document in a care plan and not placed beside "elimination" as a sub heading , filled in once and left . I've been working on a webtool to allow this to happen, see www.lastsay.co.uk.
    We need to make a start and not wait until people are in denial of death and already feel out of control and helpless.

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  • Here here Tony , absolutely spot on !

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