1. End of Life Care Nottinghamshire Care Homes Forum Helen Scott, Nottinghamshire County tPCT September 2008

2. What is End of Life Care? Adults with any advanced, progressive, incurable illness Adults with any advanced, progressive, incurable illness Care given in all settings Care given in all settings Care given in the last year(s) of life Care given in the last year(s) of life Patients, carers, family members Patients, carers, family members

3. End of Life Care tools Gold Standards Framework Gold Standards Framework Liverpool Care Pathway Liverpool Care Pathway Advance Care Plans; inc Advance Decisions to Refuse Treatment and Preferred Priorities for Care Advance Care Plans; inc Advance Decisions to Refuse Treatment and Preferred Priorities for Care

4. GSF Principles Communication Communication Co-ordination of the person’s care Co-ordination of the person’s care Control of symptoms Control of symptoms Continuity of care Continuity of care Continued learning Continued learning Carer support Carer support Care of the dying Care of the dying

5. Liverpool Care Pathway Empowers health and social care professionals to deliver high quality proactive care to dying patients and their relatives regardless of diagnosis Empowers health and social care professionals to deliver high quality proactive care to dying patients and their relatives regardless of diagnosis Provides goals of care for the last few days of life Provides goals of care for the last few days of life 3 sections: initial assessment, ongoing assessment, care after death 3 sections: initial assessment, ongoing assessment, care after death

6. Advance Care Planning Ongoing, holistic process Ongoing, holistic process Encompasses Advance Decisions to Refuse Treatment and Preferred Priorities for Care Encompasses Advance Decisions to Refuse Treatment and Preferred Priorities for Care Explores wishes and preferences Explores wishes and preferences Must be documented and communicated to be effective Must be documented and communicated to be effective

7. End of Life Care Skills Foundations in palliative care Foundations in palliative care Symptom control; MTCN guidelines, LCP guidelines, pocketbooks Symptom control; MTCN guidelines, LCP guidelines, pocketbooks Syringe driver competence Syringe driver competence Terminal care; LCP goals Terminal care; LCP goals Teamwork; residents, carers, professionals Teamwork; residents, carers, professionals

8. Plans Training Training Implementation and audit of GSF, ACP, ADRT, LCP in all settings Implementation and audit of GSF, ACP, ADRT, LCP in all settings Anticipatory prescribing Anticipatory prescribing Psychological support Psychological support Care coordination Care coordination Information resources Information resources

9. Questions?