1. End of Life Care Nottinghamshire Care Homes Forum Helen Scott, Nottinghamshire County tPCT September 2008

2. What is End of Life Care? • Adults with any advanced, progressive, incurable illness • Care given in all settings • Care given in the last year(s) of life • Patients, carers, family members

3. End of Life Care tools • Gold Standards Framework • Liverpool Care Pathway • Advance Care Plans; inc Advance Decisions to Refuse Treatment and Preferred Priorities for Care

4. GSF Principles • Communication • Co-ordination of the person’s care • Control of symptoms • Continuity of care • Continued learning • Carer support • Care of the dying

5. Liverpool Care Pathway • Empowers health and social care professionals to deliver high quality proactive care to dying patients and their relatives regardless of diagnosis • Provides goals of care for the last few days of life • 3 sections: initial assessment, ongoing assessment, care after death

6. Advance Care Planning • Ongoing, holistic process • Encompasses Advance Decisions to Refuse Treatment and Preferred Priorities for Care • Explores wishes and preferences • Must be documented and communicated to be effective

7. End of Life Care Skills • Foundations in palliative care • Symptom control; MTCN guidelines, LCP guidelines, pocketbooks • Syringe driver competence • Terminal care; LCP goals • Teamwork; residents, carers, professionals

8. Plans • Training • Implementation and audit of GSF, ACP, ADRT, LCP in all settings • Anticipatory prescribing • Psychological support • Care coordination • Information resources

9. Questions?