End of Life Care

End of life care is care that helps all those with advanced, progressive, incurable illness to live as well as possible until they die. It enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last phase of life and into bereavement. The definition of the beginning of end of life care is variable according to individual person and professional perspectives. Generally, end of life care will be the last year of life but for some the start may be at the time of diagnosis of a condition which usually carries a poor prognosis, for example motor neurone disease, advanced liver disease or dementia where capacity may become an issue.

Improving the experience of end of life care for patients and their carers is a strategic priority across NHS South of England. Studies suggest that up to 75% of us would choose to die in our own homes if possible, but our wishes are not always known to those who care for us. NHS South of England supports the national Dying Matters campaign to encourage people to talk to their loved ones about their wishes.

The vision for end of life care across NHS South of England is to improve choice and quality as efficiently as possible. The programmes to meet this bring together all of the local health and social care communities to improve end of life care.

The programme teams have been working with Primary Care Trusts, Clinical Commissioning Groups and Local Authorities to ensure that they have structures in place which include the independent and voluntary sector to support local implementation of the programmes. These programmes centre on four areas of work:-

• Identification of those in the last year of life
• Establishment of locality wide End of Life Care Registers also known as Palliative Care Coordination Systems so that people’s wishes can be shared
• Advance Care Planning for all of those who would like it
• Enhanced Community Care Services to enable people to die in their place of choice

Across NHS South of England clear plans are in place to ensure the improvements in End of Life Care are sustained.

Training

Training in end of life care is being rolled out across NHS South of England (contact details for the Central area can be found on Page 4 of the Adult Advance Care Planning (ACP) Toolkit). Alongside all of this training several modules of EoLC e-learning are freely available to anyone who would like to access them, these include communication skills and ACP which can help you in ACP whether you are considering your own future wishes or you are helping a family/friend or a patient/resident consider their wishes.

For these modules please access www.endoflifecareforall.com

There are also more detailed modules which cover all of the different aspects of EoLC and can therefore help clinicians to discuss these with their patients or residents.

For these modules please access www.e-elca.org.uk