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The big question: will the new Priorities of Care improve patients’ and relatives’ experiences of end-of-life care?


A new approach to caring for dying patients has been launched to replace the now defunct Liverpool Care Pathway.

The new Priorities for Care, which are backed by government, are designed to ensure the wishes of patients are respected and that care is tailored to their needs.

These guiding principles were drawn up by a group of 21 organisations under the umbrella title of the Leadership Alliance for the Care of Dying People.

It includes the Royal College of Nursing, the Nursing and Midwifery Council, Marie Curie Cancer Care and Macmillan Cancer Support.

The new guidelines, which form part of a wider report called One Chance to Get it Right, stress the importance of clear and sensitive communication between nurses and the person who is dying, their family and friends.

Do you welcome this new guidance?



Readers' comments (5)

  • michael stone

    Except that it is too long, and at least in part legally incorrect [regarding Advance Decisions as described by sections 24 - 26 of the Mental Capacity Act], I like the report 'on the whole'.

    It stresses talking to patients and their family/friends, it stresses treating patients as individuals and not as mere 'clinical situations', and it wants more 'holistic' thinking about end-of-life. It also went into an analysis of one of my issues - inadequately-defined terminology for EoL - although its response (listing how different bodies are using different words, and explaining how the former LACDP members intend to use certain terms in the future) probably will not resolve that particular mess.

    There are clear dangers and potential advantages to the approach of 'we want local groups [of clinicians] to think it all through, and to design their own paperwork, etc, in line with our principles'.

    But it doesn't investigate some operational issues: for example, it makes no comment about potential conflicts between 'shared folders' and EPaCCS, if the patient is at home and the shared folder is more up-to-date than an EPaCCS which the 999 services might have been accessing en route. Neither does it fully investigate certain legal issues, which are very relevant, especially for EoL at home.

    What it does do, is stress that 'tick box' doesn't work properly for end-of-life - but whether things will improve or not, is yet to be seen.

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  • It MUST improve care-not just to dope patients, but to treat holistically. All nurses and Drs should be trained in palliative care. It would be better if all terminally ill patients could have the care given in hospices, but that is not possible in acute settings. Push for more hospice-type training and dedication to cover every aspect of dying patients need and say no to assisted early demise. They deserve the best

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  • michael stone

    This doesn't seem to be considered a 'big question' judging by the fact that only 2 of us have commented so far ?

    Mind you, perhaps few of the NT readership have read 'One Chance to get It Right' so far ? It isn't short, and it takes a fair while to work through it.

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  • Staff must be given adequate training for the new approach to work

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  • michael stone

    Anonymous | 8-Jul-2014 3:07 pm

    I had commented to Bee Wee that I have doubts about that aspect (that the training will be adequate) before the report came out.

    I've also commented, since the report was published, that I think this will be challenging for many nurses [despite it being legally correct]:

    'If a dying person makes an informed choice to eat or drink, even if they are deemed to be at risk of aspiration, this must be respected.'

    (page 89, section 11, of 'One Chance to Get It Right).

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