The NHS in England: the operating framework for 2007/08 sets the strategic direction for delivering healthcare in the future. Key to this is reforming and improving community services to place a greater focus on prevention, promoting well-being and delivering services in more local settings. These new services should be flexible, integrated and responsive to people’s needs and wishes.
Leadership and partnership are both critical to good palliative end of life care. However, in the King’s Fund report Future Trends and Challenges for Cancer Services in England (2006) individuals and carers identified the difficulties of moving between services. There was also a call to have a wider debate around all end of life services.
It is now widely accepted that quality education and training is essential to the delivery of quality patient care. And nowhere is that more the case than in end of life care.
Ensuring the delivery of care is the most important aspect of any service but is influenced by so many other things. Without appropriate commissioning, committed and skilled workforce, good leadership and partnership working, care delivery will be compromised.
Primary care trusts’ core function is to commission high quality services that are tailored to the needs of individual patients, and to do so in a way that maximises value for money. In essence this means buying the healthcare services for their defined population from a range of providers. PCTs do this in conjunction with practice-based commissioners who are groups of GPs within the trust boundary.
Measuring the quality and standards of a service provides not only a baseline from which to start a new project but also evidence of progress along the way. Measuring an existing service’s quality against an agreed standard helps to set the bar for what is required in each area and to identify target points for change. It can also be helpful in agreeing the component parts of systems and breaking work targets into smaller, manageable sections.
All individuals should experience a dignified death with their family and carers adequately supported in all care settings. Sadly this does not always happen.
The care of the deceased and their relatives should always be carried out with respect, dignity and empathy and in accordance with the local policy.
