What do we know now that we didn’t know a year ago? New intelligence on end of life care in England

May 23, 2012

Source: National End of Life Care Programme

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Date of publication:  May 2012

Publication type:  Report

In a nutshell: This report highlights the progress made in the implementation of the Department of Health’s End of Life Care Strategy and identifies the successes of the programme as well as those areas that need improvement. The report consists of 16 categories including:

  • place of care and death
  • latest trends in different settings
  • disease types
  • costs
  • quality of care
  • workforce and public attitudes

Examples of areas for improvement highlighted by the report include unplanned emergency care and advance care planning with a view to improve the experience of patients and their families but also to deliver more cost-effective care.

Length of publication: 28 pages


Understanding the cost of end of life care in different settings

April 26, 2012

Source: Marie Curie  

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Date of publication: February 2012

Publication type: Report

In a nutshell: This report from Marie Curie’s considers the economic impact of providing care to patients in the community, rather than in the acute setting and presents a clear argument for the development of high-quality community-based care.  Marie Curie estimate:

  • community care at the end of life costs £145 per day
  • specialist palliative in-patient care costs £425 per day
  • changing the setting of care could reduce daily costs by £280.
  • between 355,000 and 457,000 patients need palliative care annually.
  • If community services were developed to enable just 30,000 patients to reduce their hospital stay by just four days, there could be a saving of £34 million.

Length of publication: 8 pages

End-of-life care pathways as tools to promote and support a good death: a critical commentary

February 23, 2012

Source:  European Journal of Cancer Care

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Date of publication: January 2012

Publication type: article

In a nutshell:  This paper challenges whether end-of-life care (EoLC) pathways facilitate the accomplishment of a ‘good death’. EoLC pathways are widely recommended as ‘best practice’. However there are concerns about the efficacy of care pathways with regard to their impact on patient care.  Further examination of two EoLC pathways reveals how biomedical aspects of care are privileged. Despite this evidence indicates EoLC pathways may facilitate a particular type of ‘good death’, especially one associated with the dying process and framed within biomedicine.

Length of publication: 11 pages

Acknowledgement: BNI

An electronic resource to support staff providing end of life care

January 28, 2012

Source: Nursing Standard, November 2011, 26, (12), p.41-46

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Date of publication: November 2011

Publication type: Article

In a nutshell: The End of Life Care Strategy challenges care providers to develop effective care in all settings.  Each care setting faces different challenges. One acute NHS trust decided to focus on the specific challenges of identifying and diagnosing dying patients in order to provide appropriate palliative care. They developed an electronic resource tool to aid prognostication and provide a single point of reference to help practitioners to improve end of life care for patients in the hospital setting.  This article reports on the results of a six-month pilot.

Length of publication: 6 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Issues facing commissioners of end-of-life care

November 28, 2011

Source: The King’s Fund

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Date of publication: September 2011

Publication type: Report

In a nutshell:  End-of-life care services are typically funded and delivered by a range of organisations including the NHS,  local government, the voluntary sector and independent agencies, charities and through informal or formal donations. This growing complexity coupled with demands on end-of-life care services means that commissioning services is challenging.  This document addresses the current complex arrangements around EoLC funding and highlights barriers as well as the opportunities commissioning offers.

Some of the issues that make end-of-life care important for commissioners include:

  • demographic changes =  an increase in the number of deaths and also increases in the number of people living with complex and co-existing  diseases
  • government’s end-of-life care strategy clearly emphasises that eolc is a local commissioning priority
  • several monitoring and incentive programmes are aimed at improving the quality of care.

Length of publication: 24 pages

Acknowledgement: The King’s Fund

Achieving the preferred place of care for hospitalized patients at the end of life

May 27, 2011

Source: Palliative Medicine June 2011 v.25(4) p333-336

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Date: June 2011

Publication type: Article

Publication length: 4 pages

In a nutshell: The Department of Health end-of-life strategy contains a number of quality markers which include taking into account patients’ wishes for their final place of care. An audit was conducted on discussion of preferred place of care (PPC) for all patients referred to the hospital palliative care team who died during the audit period. The data highlighted the need to distinguish between preferred place of care and preferred place of death. Patients’ wishes regarding PPC change as death approaches. A greater number of patients wished to die in hospital than was expected.

Some important notes: Contact your local health library for a copy of this article. Follow this link to find your local health library.

Quality Markers and Measures for Bereavement; Consultation

May 26, 2011

Source:  Department of Health

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Date of publication: March 2011

Publication type: Consultation

In a nutshell:  Quality markers and measures for end of life care were published in 2009 to help providers and commissioners implement the End of Life Care Strategy (2008).  In the orginal document however, there were no quality markers specifically for bereavement care or spiritual support for EoLC for patients.  To remedy this the Stategic Health Authority End of Life Care Pathway Chairs requested that markers be drafted to cover those particular areas.   This work is now complete and ready for the consultation phase.

Length of publication:  15 pages

Acknowledgement: National End of Life Care Programme