Future for End of Life Care

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Future for End of Life Care?
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Background

• Healthcare for London A framework for action
• The health needs of the population
• Radical thinking about how to deliver services
  that compare with the best in the world and
  provide the best possible outcomes for patients
• Future developments in technology, drugs, and
  clinical advances
• Current and emerging national policy.
• End of Life Care Clinical Group
• What is meant by end of life care?
• Current issues in end of life care?
• Understanding the end of life
• What would good practice look like?

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Issues

• There is lack of discussion in society about
  death and dying
• Inadequate planning for individuals at the end of
  their lives
• Most people are dying in hospital when they would
  rather die at home or in a hospice
• The quality of end of life care provided is
  highly variable
• Inadequate planning at the system level
  resources, responsibility and co-ordination

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What would good practice look like?

• Strong sector wide specialist commissioning
  function
• recognition of End of Life Care Service Providers
  (ELSPs) (managed networks)
• Care pathway for end of life patients
• Detailed service specifications
• Managed networks across providers
• Contracts for integrated and comprehensive
  service provision
• Allocated finance

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Method

• Integrated managed care system at the end of
  life responsibilities of ELSPs
• The care at the End of Life Register
• all advanced and progressive illness use of
  triggers
• managed by ELSPs
• Systemic assessment of needs
• Co-ordination of services
• Choice and anticipatory planning
• Benefits

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Drivers

• A system of triple assurance for a co-ordinated
  and integrated approach
• Establishing mechanisms to ensure a systemic
  approach
• Named clinical professionals
• Named leads within ELSPs/managed network
• Regular audit and review
• Guardian role

• Putting in place a strong underpinning and
  supportive framework
• Role of voluntary and community sector
• Coterminous service provision within ELSPs
• Appropriate and adequate training in EoLC and
  communication skills
• Links with all healthcare services

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