National End of Life Care Strategy Implementation Claire Henry Programme Director National End of Life Care Programme 20 October 2009

Role of the National End of Life Care Programme To support SHAs/PCTs/LAs to improve end of life care To share good practice across all aspects of the strategy to include Local profile raising regarding end of life care issues strategic commissioning by PCTs and LAs Each step of the end of life care pathway Workforce development Environments of care To develop and work in collaboration with end of life care intelligence network Measurement /Quality Markers

The end of life care pathway Discussions as the end of life approaches • Open, honest communication • Identifying triggers for discussion Step 1 Step 2 Assessment, care planning and review • Agreed care plan and regular review of needs and preferences • Assessing needs of carers Step 3 Coordination of care • Strategic coordination • Coordination of individual patient care • Rapid response services Step 4 Delivery of high quality services in different settings • High quality care provision in all settings • Acute hospitals, community, care homes, hospices, community prisons, secure hospitals and hostels • Ambulance services Step 5 Care in the last days of life • Identification of the dying phase • Review of needs and preferences for place of death • Support for both patient and carer • Recognition of wishes regarding resuscitation and organ donation Step 6 Care after death • Recognition that end of life care does not stop at the point of death. • Timely verification and certification of death or referral to coroner • Care and support of carer and family, including emotional and practical bereavement support Spiritual care services Support for carers and families Information for patients and carers 3

The end of life care pathway Step one – identifying people who are approaching the end of life

Kidney Care Pathway

The end of life care pathway Step two – assessment and care planning

The end of life care pathway Step three: co-ordination of care Locality registers 8 pilots Camden PCT Provider Services Royal Marsden NHS Trusts and Connecting for Health Sandwell PCT Salford PCT with Salford Royal NHS Foundation Trust Weston Area Health Trust NHS Brighton and Hove Leeds Teaching Hospital NHS Mid Essex

Care in different settings Care homes Lancaster University and Nottingham University study found Leadership was important Access to key staff was variable Access to information, resources and training was variable There was an inverse care law operating – homes which were not implementing end of life care tools had less access to support and became more isolated Extra Care Housing: Is it that time already? + resource pack launched July 2009

National End of Life Care Programme workstreams Pre pathway Raising Awareness Support NCPC Commissioned literature review Discussions as the end of life approaches Communications skills (introductory, intermediate, advanced) 12 pilots Clinical triggers - kidney, dementia heart Transition services from children to adult services Step 1 Step 2 Assessment, care planning and review Advance care planning - patient and professional information – planning for your future care PPC ADRT information for patients Assessment framework - cancer and CAF Step 3 Coordination of care Locality wide registers pilot 8 Pilot sites Integrated care pilots Personal budgets Step 4 Delivery of high quality services in different settings Acute Hospitals (scoping) Hospices – N3 Primary care – GSF/ADA Transforming community services Care homes (volunteers) Extra care housing Prisons Hostels Step 5 & 6 Care in the last days of life and care after death LCP version 12 /hospital Audit Environments of care - King’s Fund Measurement Intelligence network quality markers User involvement, Information for patients and carers – NHS choices Workforce – competences, E-learning, methods of delivery Commissioning, currency and pricing, provider development, service improvement Cross boundary working/sharing good practice communications strategy events website

EoLC Programme newsletter Contact us: Website: www.endoflifecareforadults.nhs.uk Email: information@eolc.nhs.uk Tel: 0116 222 5103 EoLC Programme newsletter