The government has made 6 commitments to the public to end variation in end of life care across the health system by 2020. These are:
- honest discussions between care professionals and dying people
- dying people making informed choices about their care
- personalised care plans for all
- the discussion of personalised care plans with care professionals
- the involvement of family and carers in dying people’s care
- a main contact so dying people know who to contact at any time of day
The commitments are in response to an independent review of end of life care.
NHS and care professionals will be expected to reflect these commitments in their work. New measures will be developed to ensure local health and care leaders are meeting the standards expected of them.
Dealing with variation in care across the week is essential to meeting these commitments and the government will support the NHS and local authorities to do this.
Plans include ensuring experts can provide specialist support on end of life care by acting as a first point of contact for anyone who needs them, as part of the newly developing urgent and emergency care hubs in all local areas. These experts will be available to help dying people or the families of dying people, who need support with symptom control or deteriorating conditions late at night or at the weekend, as well as clinicians who have questions or need additional support 24 hours a day, 7 days a week.
There will be a focus on improving the training for clinicians including a national plan aimed at sharing best practice among NHS staff. Pilots in Southend and Airedale will be launched to trial new ways to support clinicians to initiate meaningful conversations with dying people about serious illnesses. A potential new role, a care coordinator, will also be tested with the aim of helping patients have more choice and control at end of life. New innovative community care pilots including 24/7 specialised nursing services for end of life care will be tested in a number of areas.
Health Minister Ben Gummer said:
Our commitment is that every person nearing the end of their life should expect a good death: attentive, dignified and compassionate care.
To do this, we will address poor care where it exists and accelerate improvement across the health and social care system in England. Already there are exemplary models of good care and we will ensure that where care is not so good we can learn from what is best and translate it to where it is needed most.
Claire Henry MBE, who chaired the independent board, said:
I’m pleased by the overall vision set out in the government response. They have clearly acknowledged our report, and taken its recommendations seriously.
To implement the new national commitment for end of life care, we all need to work together to make this a reality, to ensure that a real difference can be made to people nearing the end of life and their families. It will be vital that we continue to work with the government to ensure all these commitments are realised as part of all future care delivery. We know that numbers of people dying each year are starting to increase, and we’ll only get one chance to get it right for them.
Existing successful initiatives will also be extended, including a programme aimed at helping hospitals to improve end of life care, with tailored support from experts. Additionally, the NHS will support the increased use of electronic patient records for people nearing the end of their life to enable the recording and sharing of end of life care choices by 2020.