Friday 13th July 2012
Laura Wigley, Macmillan Palliative and End of Life Care Programme Manager, on how the Living Well booklet is helping staff to improve care.
Person-centred care is care that responds to, and is guided by, an individual’s preferences, needs and values. Yet, despite being a prominent feature of national policies for several years, there remains a lack of guidance on how such care might be achieved.
In North East Yorkshire and Humber Clinical Alliance (NEYHCA), we are addressing this by using Living Well: thinking and planning about the end of your life, a booklet developed by Lancashire County Council and Helen Sanderson Associates. Living Well contains a number of person-centred ‘tools’ to help frame conversations with patients and their families.
The tools prompt patients and families to consider their thoughts and feelings about what is important to them now, and what they would like in the future. The tools facilitate conversations on a variety of issues and concerns (see examples on the downloadable pdf that we link to at the end of this page). The information is then used to shape the care and support the person receives.
The guide has been tested by a range of partners, and patients and carers. Feedback indicates that it helps both patients and professionals achieve better end-of-life care:
‘The tools help you put things in perspective; writing it down made it easier to share my hopes and fears with my family’ (Tony, service user).
‘[The tools] gave the team greater insight into who he was, what was important to him, what made him tick; things that might have otherwise taken us weeks to find out’ (Sarah, physiotherapist).
Training and roll out
Although the guide can be used by anyone (professional, patient, carer), NEYHCA partners are encouraged to undertake accredited training before using the tools, an approach that has been adopted elsewhere. Where direct training of staff is not possible, trained individuals support their colleagues before, during and after using the tools with patients. It is hoped that this will ensure a level of quality and consistency.
Throughout the testing process, Living Well was used by various professionals and volunteers.
More recently, the tools have been used within care homes to help plan for end-of-life care, and for people with dementia to begin conversations early about what they would like to happen in the future. Elsewhere, the information gathered has been used in Gold Standard Framework meetings in GP surgeries to convey the patient’s voice and preferences.
Embedding into practice
We are continuing to embed person-centred tools and approaches into everyday practice, by identifying opportunities for use and creating peer support networks to maintain quality.
The original team of partners that tested the guide will be reconvening to facilitate further implementation, as well as to develop a version specifically for carers. Meanwhile, work has also begun with colleagues in Scunthorpe to look at how Living Well fits into their current processes and practices to help drive up the quality of end-of-life care for all.
You can download an example copy of Living well.