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Modernisation and Reform of Palliative and End of Life Care in Northern Ireland

Each year approximately 15,000 deaths occur in Northern Ireland. Many of theses are as a result of deteriorating health due to a chronic disease such as heart failure, chronic obstructive pulmonary disease, cancer and frailty in old age. It is estimated that two thirds of the people who die within any year would benefit from a period of palliative care prior to and during their last year of life. Added to this, are the supportive needs of the family and carers.

 
Vision for Quality Palliative and End of Life Care
 
"that any person with an advanced non-curative condition, lives well and dies well irrespective of their condition or care setting. This requires a philosophy of care that is person-centred and which takes a holistic approach to planning, co-ordinating and delivering high quality, equitable and reliable care that enables people to retain control, dignity and, crucially, choice in how and where their care is delivered to the end of their life"

'Living Matters, Dying Matters' A Palliative and End of Life Care Strategy for Adults in Northern Ireland  ( DHSSPSNI, 2010)

 
Generic Standards
 
The generic standards for palliative and end of life care, can be found in the Service Frameworks for Cardio vascular, Cancer and Respiratory Conditions.  The Standards  focus on identification and assessment of care needs, access to integrated and responsive services, open communication, the management of symptoms and the availability of choice in care provision as essential elements of quality palliative and end of life care. Commissioning health and social care using these standards will drive up the quality of palliative and end of life care across all settings by ensuring that the standards become embedded within commissioning service specifications as well as supporting audit systems to monitor quality improvement.
 
Generic Standards for Palliative & End of Life Care (DHSSPS)

Standard 1

Health and Social Care professionals, in consultation with the patient, will identify, assess and communicate the unique supportive, palliative and end of life care needs of that person, their caregiver(s) and family.

 
 

Standard 2

Patients, carers and families have access to responsive, integrated services which are co-ordinated by an identified team member according to an agreed plan of care, based on their needs.

 

Standard 3

People with advanced progressive conditions, their caregivers and families, will be informed about the choices available to them by an identified team member, and have their dignity protected through the management of symptoms and provision of comfort in end of life care.

A number of mechanisms are in place to enable all services to make this vision reality.
 
Regional Community Facing Palliative Care

The generic palliative care standards have informed the development of a regional community-facing model for the delivery of palliative care. This model of care, which was developed under the auspices of NICaN’s Supportive and Palliative Care Network, is part of a wider programme of work to reform and modernise palliative and end of life care in Northern Ireland.

The regional model provides a framework for the commissioning and delivery of care that is centred on the patient, their family and carers. The model focuses on the provision of palliative and end of life care within the community underpinned by supportive hospital and specialist provision. The model’s core values including equity, respect, empowerment and choice, reflect the principles of the generic palliative care standards as well as the standards set out in “Improving the Patient and Client Experience”.

Six core components form the basis of the model. These are listed below and are incorporated throughout the Strategy:

  •  Professional and Public Awareness
  •  Identification of Palliative Care
  • Holistic Assessment
  • Integration of Services
  • Co-ordination of Care
  • End of Life Care and Bereavement Care

 

Priorities for Action Target (PfA)

 The Priorities for Action (PfA) target for 2009-2011 provides a mechanism to improve the quality of care and improve services for patients and families who require palliative and end of life care. It serves to guide commissioners in the planning of palliative and end of life care services and service providers in how these services should be designed and implemented. The PfA target states that “by March 2011, Trusts should establish multi-disciplinary palliative care teams, and supporting service improvement programmes, to provide appropriate palliative care in the community to adult patients requiring such services”. To support the achievement of this target a Regional Lead for Service Improvement in palliative and end of life care has been appointed to liaise with the HSC Board and to support the 5 Trusts to achieve the target. All Trusts will be monitored to assess their progress towards and achievement of this PfA target. 
  

Click here for information on the Target Definitions and Monitoring Guidance.

 
For further information on the PfA please contact Mrs Heather Weir on 028 9056 5860 or email heather@cancerni.net.    

 

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