BIOETYKA / ETYKA MEDYCZNA

BIOETYKA / ETYKA MEDYCZNA - Przeglądy aktów prawnych

End of Life Care Strategy. Promoting high quality care for all adults at the end of life – Department of Health 2008

Aim of this end of life care strategy s.33

In the past, the profile of end of life care within the NHS and social services has been relatively low. Reflecting this, the quality of care delivered has been very variable. The aim of this strategy is to bring about a step 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 socioeconomic status. High quality care should be available wherever the person may be: at home, in a care home, in hospital, in a hospice or elsewhere. Implementation of this strategy should enhance choice, quality, equality and value for money.

Chapter 3: The end of life care pathway s. 45

3.2 Individuals differ in many ways as they approach the end of life. No two people will have an identical end of life care pathway. For each individual many different factors will impact on their needs and preferences for care.

A Working Definition of End of Life Care s.47

End of life care is care that: Helps all those with advanced, progressive, incurable illness to live as well as possible until they die. It enables the supportive and palliative care needs of both patient and family to be identified and met throughout the last phase of life and into bereavement. It includes management of pain and other symptoms and provision of psychological, social, spiritual and practical support.

Chapter 4: Care in different settings s. 79

Introduction

People approaching the end of life require care in a variety of different settings. This chapter sets out the actions which need to be taken to ensure the provision of high quality care in:

• Acute hospitals;
• The community (mainly in a person’s home);
• Care homes and sheltered and extra care housing
• Hospices;
• Community hospitals;
• Ambulance services;
• Prisons and secure hospitals; and
• Hostels for the homeless.

The Gold Standards Framework s. 85

4.19 The QOF has an indicator set for palliative care. Originally linked with cancer care, this indicator is now providing the impetus to improve end of life care for all those with advanced disease. Each GP practice establishes a register of all those who require end of life care. The ongoing care of those on the register is regularly reviewed at multidisciplinary planning meetings. The creation of the register enables the wider practice team to provide more appropriate and patient focused care, such as reception staff being aware of the need to prioritise communication from relatives to clinical staff if the person is on the register.

Chapter 5: Support for carers and families s. 107

5.3 Three key principles should apply to carers of people approaching the end of life. These are that:

• Carers are central to the team that cares for somebody at the end of life and they should be treated as ‘co-workers’ with the health and social care team;
• Carers have their own needs. Those providing a substantial amount of care on a regular basis are entitled to a community care assessment by their local authority; and
• The condition of the person who is cared r should not affect how the carer is treated, or the services the carer may be able to access.