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End-of-Life Care

Volume 593: debated on Thursday 26 February 2015

The independently led review of choice in end-of-life care has published its advice to Government today. I commissioned this review in July 2014 to look into how quality and experience for people approaching the end of life can be improved by expanding choice. The review was chaired by Claire Henry MBE, chief executive of the National Council of Palliative Care.

This Government are committed to ensuring that people nearing the end of their lives get high quality, compassionate care which is focused on their individual needs and preferences.

I welcome the review’s advice, which proposes that a “national choice offer” for everyone in need of end-of-life care should be in place by 2020 and sets out the actions needed to deliver this. As the review rightly notes, many people in England already receive good end-of-life care, focused on their choices, and I want to pay tribute to everyone involved in this care, both staff and carers.

The review’s advice has outlined a series of actions to ensure that everyone receives good care at this important point in their lives. This advice covers:

Early identification of people who are approaching the end of life.

Greater use of:

advance care planning to record people’s choices and preferences; and

electronic systems which enable records to be shared among all those involved in the person’s care and allow people to access and update their own records.

24/7 care for people being cared for outside hospital.

A named senior clinician with overall responsibility for the delivery of good care for each person approaching the end of life.

Enabling family members and those important to the individual to be involved in discussions about care preferences and ensuring carers have support.

Training and work force numbers to ensure that staff are supported to deliver good care.

The steps that health and social care organisations can take to create the right conditions to improve choice, including guidance for commissioners, working with the voluntary sector—in particular hospices—and robust metrics to measure improvements.

The review advises how more people can be cared for in their own home, as this is a key choice for many people approaching the end of their lives. It sets out the savings that more out-of-hospital care can achieve in acute care, as well as the additional investment needed in community health and social care services.

The Government will work with organisations in the health and care system to consider this advice and enable a full response later this year.

In the meantime, I can say that we fully support the review’s vision that every person should receive care in line with their choices and preferences, and we urge local health and care organisations to work together to ensure that this is achieved for as many people as possible.

In particular, we recognise that interoperable electronic health records play a central role in ensuring that people’s preferences and choices are recorded and shared with all involved in their care. Examples from across the country have shown that where these systems exist they can deliver real benefits to people at the end of life and form an important part of the culture change needed to deliver choice and person-centred care.

To help this happen, the Government accept the review’s advice that each person approaching the end of life should have a fully interoperable electronic health record, and should be able to access and add to their own records. This is in line with the ambition set out for all patients in the “NHS Five Year Forward View”.

I would like to thank the chair and the review’s programme board for their hard work and commitment. Finally, I would also like to thank all the contributors to the review, and in particular the people who responded to the review’s public engagement exercise.

A copy of “What’s important to me: A Review of Choice in End-of-life care” is available in the Library. Copies are also available at: departments%5b%5d=department-of-health

Attachments can be viewed online at: http://www.