End-of-life care

The NHS Confederation welcomes any move to give patients and carers more choice about care at the end of life.

We have been involved in developing the Department of Health's end of life care strategy and the NHS End of Life Care Programme. The programme helps healthcare professionals improve end-of-life care for patients, regardless of their disease and widen the pool of staff trained in palliative care. The aim is to build local capacity, capability and clinical leadership.

Three best practice tools have been developed to support this work:

• gold standards framework for community palliative care
• Liverpool care pathway
• preferred place of care.

End of life care strategy

This was published in July 2008, with £286m extra funding to support it. It was developed with the help of the clinical pathway groups set up in each SHA as part of the Next Stage Review, and focuses on facilitation of people's wishes to die at home.

The proposed model of end of life care is that of an integrated care pathway developed and commissioned in partnership between PCTs and local authorities, with care planning according to individual preferences. Particular proposals include:

• Work to raise the profile of end of life care and to change attitudes towards death;
• Commissioners should review quality of end of life care in different settings, using quality standards currently being developed
• SHAs should consider best way to ensure training is available in EoL care
• A 'major workforce development initiative' to help staff identify those approaching the end of life
• Availability of medical, nursing and support in the community 24/7
• Care plan should contain any advance directives about care at end of life, and should be available to those who may have a legitimate reason to access it.
• PCTs should use the Marie Curie Delivering Choice programme in terms of co-ordination of care and a single point of access, as well as developing registers of those at risk.

Views sought on quality markers

The Department of Health is now consulting on a range of end of life quality markers (previously known as 'national standards') to cover all sectors of healthcare.

The NHS Confederation is preparing a response and is keen to hear members' views. Read the consultation document and email your views to elaine.cohen@nhsconfed.org by 16 January 2009.

How we involve members

We hold specific seminars and meetings to inform our policy positions - invitations either appear in our email bulletin Interchange Alert or are sent out individually. We have regular meetings bringing together key stakeholders with NHS Confederation members.

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