A new set of principles for ensuring consistent end of life care in hospitals, care homes and in hospices has been published.
Ambitions for Palliative and End of Life Care gives details of the work that several organisations – including the Care Quality Commission – have agreed to do to improve local services so that people who use services have fair access to care, and that any care is based on individual needs.
We assess end of life care in acute hospitals as one of the eight core services to determine if a service is providing care that is either: Outstanding, Good, Requires Improvement or Inadequate.
We also inspect and assess end of life care in community hospitals, specialist palliative care community services and community health teams.
Care homes are not given a rating for the quality of end of life care, but as part of each inspection, our inspectors always ask a specific question about care in the last days of life.
The six ambitions in the publication are set out below:
Each person is seen as an individual
Each person gets fair access to care
Maximising comfort and wellbeing
Care is coordinated
All staff are prepared to care
Each community is prepared to help
Our role is to make sure services adopt these principles, and to make sure there is continuous improvement.
Commenting on Ambitions for Palliative and End of Life Care, Professor Edward Baker, Deputy Chief Inspector of Hospitals, said: “The Care Quality Commission welcomes the ethos of the Ambitions that a person’s care in the last stage of their life should be as good as it can be.
"Our role is to inspect the quality of end of life care services. We know from our inspections so far there are services that are providing good and outstanding care for people at the end of their lives across hospitals, care homes and hospices.
“However, there are many services that are not delivering this. The priority now must be for services in all areas to adopt the Ambitions and take action to ensure that services are consistently of high quality.
"Where people are cared for – whether that is in a hospital, a nursing home, in a hospice or in a person’s own home – should not matter. What is important is that the person is able to access co-ordinated and individual care based on their needs, delivered with compassion and sensitivity by caring health and care professionals and that there is regular and effective communication between staff and the dying person and their family.
“We found variation in the quality of end of life care, which has prompted a thematic review on the inequalities and variation of care, particularly examining why certain groups such as people with a diagnosis other than cancer, people with dementia, people from BAME groups, people who identify as LGBT and people with mental health needs have less than positive experiences.
“We are committed to ensuring the quality of end of life care continues to improve across all the services that we inspect.”
Our evidence shows that people from particular groups experience end of life care which is of poorer quality and does not always meet their needs. This is why we are focusing our review on the following priority groups, in particular:
People with a diagnosis other than cancer
People aged over 75
People with dementia; People from BAME groups
and Other groups of people who may have specific needs, such as people with mental health needs, people with learning disabilities, people who identify as LGBT, people who are homeless, prisoners, travellers and gypsies
During the review, we want to develop our understanding of the barriers which prevent people from receiving good quality and joined-up end of life care.
We will identify examples of good local practice that others can learn from. The review will also identify the actions that need to happen nationally so that the inequalities in end of life care services can be addressed.
The findings are due to publish spring 2016.