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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)

  • michael stone

    Anonymous 15 July, 2016 9:17 pm

    The Nursing Times team - unless I misunderstand them - consider there is 'bullying' and NT has been removing 'bullying comments' aimed at me, somewhat to my annoyance.

    I don't see how I can disrupt a discussion between people who want to discuss something, and who are not interested in my comments: I give you a dinosaur and a name, so surely it isn't difficult to ignore my comments if you wish to do that !

    The lack of analytical reasoning on this website in connection with posting under 'Anonymous' compared to posting under an identifier such as 'SweetyPie 56' is disturbing.

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  • michael stone

    To 15 July, 2016 9:17 PM:

    The NT team have stated that in their opinion there is bullying going on in the comments to:

    https://www.nursingtimes.net/news/reviews-and-reports/policy-overload-affecting-end-of-life-care-provision/7006208.article




    Nursing Times

    Nursing Times11 July, 2016 4:44 pm

    Hi Michael,

    There has been an increase in what we would describe as bullying comments on the site recently. We are therefore monitoring comments more stringently and simply removing anything that is clearly offensive.

    Where possible we're trying not to disrupt the flow of debate but sometimes this is unavoidable.

    Where a comment may by construed as offensive, but this was perhaps not the author's intention, we are including a link to terms and conditions to explain our decision to remove the comment. However the comment you refer to was a clear breach of our terms and conditions and we are confident the author knows this.

    Thank you for commenting!
    Nursing Times

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  • I have been working in Nursing Homes in different capacities for over 30 years and I have been involved in closing down some of the hospital wards for the elderly which had been designed and operated by so called experts. So I am not surprised when the "anonymous" clan congregate on people such as MICHAEL STONE and deride him the way they do.All I can say to Michael is please stick to your stance and keep at it. The people that deride you have not a clue when it comes to discussing and debating ,they are not used to people such as yourself being allowed to express their opinions as this is strictly forbidden in their working environment I still have difficulties getting our Nursing Staff to do this and be proud of what they have achieved.

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  • michael stone

    Hi Gerald,

    Thanks for your supportive comments.

    I gather from the odd thing I've read, that these days people are 'taught' how to construct an 'argument'. I never was - but I suppose you don't acquire science degrees, without being able to cobble together 'a logical argument'.

    I don't think - I've no real evidence to support this - that nurses, despite their claims to professional autonomy - are trained or encouraged 'to argue'. Academics are 'argumentative by nature' and doctors seem to much faster 'to argue' than nurses, in my experience (the arguments on theBMJ {that isn't a typo - the BMJ calls its online arm 'theBMJ'} within rapid responses can be quite 'intense and heated').

    As for those hospital wards for the elderly which were unsatisfactory: I feel sure that some wards were good, some were average and some were awful, and in some cases the awfulness of the situation was not primarily down to the nurses. But is some cases, it probably was. I also think that end-of-life care has been improving in terms of the general picture , although I'm bothered that the current squeeze on resources is going to have a negative effect.

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  • michael stone

    ANONYMOUS 23 JULY, 2016 6:39 PM

    I have just reported your comment to the moderator - will you please supply your evidence that Gerald 'knows nothing about' the things he commented on ?

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  • michael stone

    MY PERSONAL POLICY ON REPORTING ABUSIVE COMMENTS TO NURSING TIMES

    I am more concerned with protecting and promoting the coherence of discussion threads, than with abusive comments directed at me. Consequently, it has been my practice to only very rarely report abusive comments directed at me.

    However, NT has requested that I do report abusive comments, which poses a conflict for me.

    My 'compromise position', will be to do the following:

    1) If an Anonymous 'abusive comment' aimed at me contains within it some point I wish to discuss, then I shall re-post the part(s) of the comment which I wish to discuss;

    2) I will then report such an abusive comment, which was posted as Anonymous, to NT;

    3) I will report - having taken step 1 if appropriate - ALL 'abusive comments aimed at me' to NT if they are posted as 'Anonymous';

    4) If an abusive comment aimed at me appears under either a real name or under a screen name, I will NOT be reporting it to NT;

    5) Irrespective of whether they appear anonymously, I will probably report to NT abusive comments which are aimed at other posters.


    I accept that my position on 5) is slightly at odds with my position at 4) - 'c'est la vie', as some people would say.

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  • Please note: We encourage all users to report any comments they deem to be abusive or spam. We review all comments reported to us.

  • Michael stone, as you were previously informed the matter of your commentary has been taken up with the editor of the nursing times.

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  • ANONYMOUS 23 JULY, 2016 6:39 PM

    I have just reported your comment to the moderator - will you please supply your evidence that Gerald 'knows nothing about' the things he commented on ?
    Dear "Anonymous" I cannot see where Michael suggests anything of the sort, but since when have I delegated advocacy to you, who ever you are ? I am more than able to put my own put of view thank you.

    Please come out of the woodwork and contribute to constructive discussions and stop being a "mous" (anonymous). Thanks to Nursing Times we can do this freely.

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