Five priority areas outlined for new end of life care approach

Five key areas have been highlighted from an independent report by the Leadership Alliance for the Care of Dying People (LACDP) outlining a new approach to end of life.

The alliance has outlined how health and care organisations should care for people during the final period of their life.

The principles include involving the dying person in decisions about their care and treatment, regularly reviewing care to ensure it is revised when appropriate and being sensitive to the needs of family members and others involved with the dying persons.

One chance

Professor Mayur Lakhani, chair of the National Council for Palliative Care said:

“We only have one chance to get it right for people who are dying, which is why today’s announcement is so important. I would urge all frontline doctors and nurses to take heed of this report and to open conversations with people who are dying and their families at the earliest stage possible. I would also encourage patients and carers to ask more searching questions about their care. This helps to create the culture change we need to ensure that everyone who is dying is well cared for and supported.

“Never again must we accept the sort of poor care that was highlighted in the independent review of the Liverpool Care Pathway or in the recent National Care of the Dying Audit for Hospitals. Excellent end of life care for all those who need it, based on people’s individual needs and wishes, must become the norm everywhere and for everyone.”

Made up of 21 national organisations, the coalition aims to create a system to improve the care of people in the last few days and hours of their lives. Members include the Department of Health, the Care Quality Commission and NICE (National Institute for Health and Care Excellence.)

Set up to respond to the recommendations outlined in the independent review of the Liverpool Care Pathway (LCP), ‘More Care, Less Pathway’, the LACDP has announced their response in the report ‘One chance to get it right.’

Compassionate care

In it they said sensitive communication must take place between care professionals and the dying resident or patient, and individual care plans including their psychological, social and spiritual support, must be created and delivered with compassion at the end of the person’s life.

Claire Henry, chief executive of the National Council for Palliative Care said:

“There can be no excuse for not treating people with dignity, compassion and respect when they are dying, at the very time that they most need this. That’s why we welcome the new Priorities for Care and the commitments given from across the Leadership Alliance to ensuring that dying people and their families get the care and support that is right for them and in accordance with their wishes.

“The challenge now is to turn ambitions into action, and principles into practice. This requires strong leadership, at local and national level, so that all those involved in end of life care see it as a priority and make care of people who are dying part of their core business.

National Conversation

“This must also be accompanied by a National Conversation about dying, so that the public and health and care professionals alike become better able to talk openly about dying, death and bereavement and to plan for the end of life before it is too late.”

The principles will dictate the way CQC inspect end of life care in a range of locations including hospitals, care homes and hospices.

Professor Sir Mike Richards, CQC’s chief inspector of hospitals, said: “The ethos of the Alliance’s five priorities for care is mirrored in CQC’s new inspection approach to make sure that people receive safe, effective and compassionate care at the end of their life.

“Where we care for someone who is dying – whether that is in a hospital, a nursing home or in a person’s own home – is irrelevant. What is important is that the person receives individual care based on their needs, delivered with compassion and sensitivity by health and care professionals and that there is regular and effective communication between staff and the dying person and their family.

“These are priorities which must be embraced across the whole NHS – and by other care providers – for it to make a real difference.” Member of the coalition, The College of Health Care Chaplains has welcomed the publication of the report.

Revd William Sharpe, registrar of the College of Health Care Chaplains said: “We are particularly pleased with its strong commitment to both assessing and providing for every individual’s needs as part of their personalised plan of care, including the recognition of the importance of their spiritual, cultural and religious needs at this time.

“Our member chaplains have a key role in delivering excellent quality end of life care and the College will support them fully as they work with colleagues in other disciplines to develop best practice models locally which enshrine the 5 Priorities for Care of the Dying Person.

“Members will work closely with staff in helping them fullfil their responsibilities and duties as outlined in the supporting document Duties and Responsibilities of Health and Care Staff, and in supporting those who are dying, and the people who are important to them.”