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In the past, the profile of end-of-life care within the NHS and social care services has been relatively low and the quality of care delivered has been very variable. To address this, the Department of Health released the End of Life Care Strategy| for England in July 2008.
The aim of the strategy was to bring about a change in access to high-quality care for all people approaching the end of life. This should be irrespective of age, gender, ethnicity, religious belief, disability, sexual orientation, diagnosis or socio-economic status. High-quality care should be available wherever the person may be, whether that is at home, in a care or nursing home, in hospital, in a hospice or elsewhere.
Implementation of this strategy should enhance choice, quality, equality and value for money. The themes set out in the strategy were built on the best available research evidence and on existing experience from:
- voluntary hospices, many of which have been beacons of excellence in end-of-life care since the foundation of the modern hospice movement by Dame Cicely Saunders at St Christopher’s Hospice in 1967
- the NHS End of Life Care Programme (2004–2007), which has contributed significantly to the roll out of programme such as the Gold Standards Framework, Liverpool Care Pathway for the Dying Patient, and the Preferred Priorities for Care
- the Delivering Choice Programme, which is being run by Marie Curie Cancer Care. This has highlighted the benefits of taking a whole systems approach to the delivery of end-of-life care.
At present, around 80,000 people die in care and nursing homes each year, representing around 16% of all deaths. However, there is accumulating evidence that significant numbers of residents are being transferred from these homes to acute hospitals in the last days, or weeks of life, when this is not necessarily their wish or in their best interests.
The strategy outlines tools, such as the Liverpool Care Pathway or equivalent tools, which can be adopted by those providing end-of-life services for use in the last days of life and care after death.
It also acknowledges the need for all health and social care staff, including those who work in care homes, to have the necessary knowledge, skills and attitudes related to care for the dying.
Living and Dying Well: A national action plan for palliative and end of life care in Scotland|, 2008
This provides a strategic focus for end-of-life care services, noting an approach that recognises and responds to individuals’ needs.
The aim of this strategy is to improve the quality of care for adults with advanced progressive illness in Northern Ireland. The strategy makes recommendations on enhancing palliative care skills among healthcare professionals to ensure a coordinated, integrated approach.
A Strategic Direction for Palliative Care Services in Wales|, 2005
This strategy brings together existing guidance, promotes good practice and makes recommendations on development of services. The aim is to provide a strategic framework that will provide a blueprint for high-quality palliative care services across Wales.
Part one - Supporting nursing homes to deliver quality care|
Part three - Resources|
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