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

2. 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

3. 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

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

5. Kidney Care Pathway

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

7. 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

8. 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

9. 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

10. EoLC Programme newsletter
Contact us:
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Tel:
EoLC Programme newsletter