Select committee inquiry
End of Life Care
Closed
What the inquiry looked at
“In June 2014 the Department of Health announced a new approach for those caring for dying people in England during the last days of their life. The approach focuses on achieving five Priorities of Care that should be applied whenever and wherever someone is dying, whether in hospital, a hospice, their own home or another location. This inquiry takes a broader look at the issue of Palliative and End of Life Care for children, young people, adults and the frail elderly, examining the way that health and social care services, and the voluntary and community sector, support people who are likely to die within 12 months, and the experience of those caring for people at the end of life. Full terms of reference for this inquiry”
The committee's words, from the inquiry page on parliament.uk ↗.
What the government said
The government responded on 20 October 2015.
Read the government's response ↗ Read the report ↗ Report an error
How the inquiry ran
Each dot is a dated item listed on this page, from the inquiry's opening on 4 November 2014 to 20 October 2015. Written evidence is not charted: only the latest 50 submissions are listed here.
- Oral evidence 2 sessions
- Report 15 Mar 2015
- Government response 20 Oct 2015
What it recommended 18 recommendations · 7 conclusions
1Every care provider should have a model in place based on the Five Priorities for...
Concluded (the committee's words)
Every care provider should have a model in place based on the Five Priorities for Care that will deliver personal, bespoke care to people at the end of life. There should be no reason for any health or care organisation not to have introduced an appropriate alternative to the Liverpool Care Pathway.
2We recommend that a senior named person in each NHS Trust and care provider is...
Recommended (the committee's words)
We recommend that a senior named person in each NHS Trust and care provider is given responsibility for monitoring how end of life care is being delivered within their organisation.
3We welcome the focus on end of life care by the Care Quality Commission and...
Concluded (the committee's words)
We welcome the focus on end of life care by the Care Quality Commission and recommend that they monitor both acute and community health care providers’ move to the new approach in their inspections and as part of their thematic review.
4Generalist staff in acute settings must be competent in identifying people who are likely to...
Recommended (the committee's words)
Generalist staff in acute settings must be competent in identifying people who are likely to be at the end of life, irrespective of their medical condition, so that they can offer specialist care where it will be beneficial. We recommend that NHS Trusts ensure that generalist staff are provided with opportunities to learn from specialist palliative care teams.
5Round-the-clock access to specialist palliative care will greatly improve the way that people with life-limiting...
Recommended (the committee's words)
Round-the-clock access to specialist palliative care will greatly improve the way that people with life-limiting conditions and their families and carers are treated. This would also help to address the variation in the quality of end of life care within hospital and community settings. We also recognise the value of specialist outreach services. We recommend that the Government and NHS England set out how universal, seven-day access to palliative care could become available to all patients, including those with non-cancer diagnoses.
6People with dementia should have equal access to end of life care as those dying...
Concluded (the committee's words)
People with dementia should have equal access to end of life care as those dying as a result of other conditions. Particular attention should be paid to discussing and documenting their wishes as early as possible following diagnosis.
7Commissioners should explicitly set out how they will provide specialist palliative care services for people...
Concluded (the committee's words)
Commissioners should explicitly set out how they will provide specialist palliative care services for people from all backgrounds in their locality, including children and adolescents, people from ethnic minority backgrounds and those living in isolated or deprived communities and how they will ensure that those with a non-cancer diagnosis can also access specialist palliative care.
8We heard that too often staff lack confidence and training in raising end of life...
Recommended (the committee's words)
We heard that too often staff lack confidence and training in raising end of life issues with their patients or delivering the right care. Training should be provided for all 44 End of Life Care health and social care staff who are likely to provide care to people at the end of life, including training in communication skills. We recommend that NHS England works with care providers to identify and roll out tailored end of life care training.
9We believe there is a role for the Government and NHS England to provide clarity...
Recommended (the committee's words)
We believe there is a role for the Government and NHS England to provide clarity and leadership with regards to the policy on advance care planning and its implementation. We recommend that the Government considers how it can further raise awareness of the mechanisms available to patients and carers under the Mental Capacity Act 2005 to make their wishes clear about end of life care. This should also include information about Advance Decisions to Refuse Treatment. The Department should provide an update to our successor Committee on the actions it has taken since publication of its response to the House of Lords Select Committee Report.
10We recommend that all staff who provide palliative and end of life care to people...
Recommended (the committee's words)
We recommend that all staff who provide palliative and end of life care to people with life limiting conditions should receive training in advance care planning, including the different models and forms that are available and the legal status of different options. Training should be developed in partnership with the National Council for Palliative Care and other non-government bodies with relevant expertise.
11We recommend that the Government engage with Age UK to understand the outcome of their...
Recommended (the committee's words)
We recommend that the Government engage with Age UK to understand the outcome of their awareness raising pilots, learning lessons that can be applied to supporting other groups as well as older people to understand the options, and developing a strategy to promote advance care planning to patients in different settings.
12We recommend that the Government carry out a review of the cost of making a...
Recommended (the committee's words)
We recommend that the Government carry out a review of the cost of making a Lasting Power of Attorney, including the impact on take up by people from different socioeconomic groups, with a view to identifying any financial barriers for those who have been unable to take out LPAs, and what support is available to those who cannot afford to use a legal route.
13At present, should a person completing the LPA application form make any error, they are...
Recommended (the committee's words)
At present, should a person completing the LPA application form make any error, they are obliged to complete a new form and start the application process again, including paying a second time. We recommend that the Government review the LPA application process, with a view to making it simpler and cutting costs for applicants.
14We recommend that the Government encourage and monitor the take up of electronic care planning...
Recommended (the committee's words)
We recommend that the Government encourage and monitor the take up of electronic care planning and Electronic Palliative Care Coordination Systems (EPaCCS), to facilitate information sharing between providers, and that they review the best mechanisms to facilitate the understanding and take up of these plans. We also recommend that the Government explore options for a universal system for End of Life Care 45 recording and filing advance care plans, with a standard template for use across England and a website dedicated to explaining the issues.
15The Department of Health has notified the Committee that NHS England is working with Health...
Concluded (the committee's words)
The Department of Health has notified the Committee that NHS England is working with Health Education England to develop a single accredited curriculum for paramedic training that will ensure that paramedics have the skills they need to resolve more calls on the phone (hear and treat) and at the scene (see and treat). We expect end of life care to feature in the new curriculum when the details are issued later in 2015.
16We recommend that the Government review the use of DNACPR orders in acute care settings,...
Recommended (the committee's words)
We recommend that the Government review the use of DNACPR orders in acute care settings, including whether resuscitation decisions should be considered in the context of overall treatment plans. This Committee believes there is a case for standardising the recording mechanisms for the NHS in England.
17We recommend that Health Education England and NHS England set out how they plan to...
Recommended (the committee's words)
We recommend that Health Education England and NHS England set out how they plan to address the shortfalls in the staffing of community care services. The Committee sees this as essential to enabling people to die at home and in other community settings including care homes and nursing homes, where that is their preference rather than in hospital. This should involve their plans for the recruitment and training of district nurses.
18We recommend that the Government clarify the eligibility criteria for the NHS Continuing Healthcare Fast...
Recommended (the committee's words)
We recommend that the Government clarify the eligibility criteria for the NHS Continuing Healthcare Fast Track Pathway and phase out the social care means test (financial assessment) for people at the end of life.
19This Committee strongly recommends that the Government provide free social care at the end of...
Concluded (the committee's words)
This Committee strongly recommends that the Government provide free social care at the end of life to ensure that no one dies in hospital for want of a social care package of support.
20We recommend that the Government set out what it intends to do to ensure sustainable,...
Recommended (the committee's words)
We recommend that the Government set out what it intends to do to ensure sustainable, long term funding for the hospice sector as part of their response to the Palliative Care Funding Review.
21We recommend that the Government ensure that their proposals for the future funding of palliative...
Recommended (the committee's words)
We recommend that the Government ensure that their proposals for the future funding of palliative care fully recognises the importance of the voluntary sector.
22Bereavement support provision is currently fragmented, with services not consistently provided around the country.
Recommended (the committee's words)
Bereavement support provision is currently fragmented, with services not consistently provided around the country. Family members and carers are too often left inadequately supported. We recommend that the Government and NHS England raise awareness amongst health and social care staff of the impact of 46 End of Life Care bereavement and provide for universal access to bereavement services in its funding plans for palliative care.
23We recommend the development of outcome measures for palliative care.
Recommended (the committee's words)
We recommend the development of outcome measures for palliative care. These must be properly evaluated and funded in order to improve the quality of care for people at the end of life.
24We recommend that the Government pursue the research priorities that matter most to people with...
Recommended (the committee's words)
We recommend that the Government pursue the research priorities that matter most to people with terminal illnesses, their families and carers and the staff providing care professionally to them, and set out what funding will be provided to ensure that future policy on palliative and end of life care is informed by a robust evidence base.
25The Five Year Forward View sets out a direction of travel for the NHS in...
Concluded (the committee's words)
The Five Year Forward View sets out a direction of travel for the NHS in England, covering all the major statutory bodies. The Department of Health and NHS England should ensure that end of life care is prioritised and embedded in future planning at all levels. They should identify named individuals who will be responsible for ensuring that the new approach to end of life care, based on the Five Priorities, is delivered nationally.
Evidence
Oral evidence sessions 2
- 28 Jan 2015No witnesses recordedparliament.uk ↗
- 20 Jan 2015No witnesses recordedparliament.uk ↗
Written evidence 77 submissions
Listed here by submitter; the evidence itself is on Parliament's website. Showing the latest 50 of 77 recorded submissions. Browse the inquiry on Parliament.
- 11 Mar 2015National Audit OfficeELC0093
- 9 Feb 2015Royal College Of General PractitionersELC0092
- 9 Feb 2015College Of ParamedicsELC0091
- 9 Feb 2015PhsoELC0090
- 9 Feb 2015My Living WillELC0089
- 9 Feb 2015CelgeneELC0088
- 9 Feb 2015General Medical CouncilELC0086
- 9 Feb 2015Nuffield TrustELC0084
- 9 Feb 2015CareELC0083
- 9 Feb 2015Parkinson's UkELC0082
- 9 Feb 2015Douglas Macmillan HospiceELC0081
- 9 Feb 2015Wales Palliative Care Strategy GroupELC0080
- 9 Feb 2015Dignity For The Aged, Dignity For The DyingELC0078
- 9 Feb 2015St Christopher's HospiceELC0076
- 9 Feb 2015The British Psychological SocietyELC0075
- 9 Feb 2015Sebastian's Action TrustELC0074
- 9 Feb 2015British Association For Counselling And PsychotherapyELC0073
- 9 Feb 2015Transition TaskforceELC0072
- 9 Feb 2015Gold Standards Framework CentreELC0069
- 9 Feb 2015Gold Standards Framework CentreELC0067
- 9 Feb 2015Motor Neurone Disease AssociationELC0065
- 9 Feb 2015British Geriatrics SocietyELC0064
- 9 Feb 2015Forest Holme HospiceELC0062
- 9 Feb 2015Childhood Bereavement NetworkELC0061
- 9 Feb 2015Anscombe Bioethics CentreELC0060
- 9 Feb 2015Society Of HomeopathsELC0055
- 9 Feb 2015Clic SargentELC0054
- 9 Feb 2015Public Health EnglandELC0053
- 9 Feb 2015International Observatory On End Of Life CareELC0051
- 9 Feb 2015St Mungo's BroadwayELC0050
- 9 Feb 2015Cambridge University Hospitals Dnacpr/Ufto Research Team And Warwick University Dnacpr Research TeamELC0049
- 9 Feb 2015Genetic Alliance UkELC0048
- 9 Feb 2015Association Of Ambulance Chief ExecutivesELC0046
- 9 Feb 2015Association Of Directors Of Adult Social Services (Adass)ELC0045
- 9 Feb 2015Sue RyderELC0044
- 9 Feb 2015Picker Institute EuropeELC0041
- 9 Feb 2015Alzheimer's SocietyELC0040
- 9 Feb 2015Urgent Health UkELC0039
- 9 Feb 2015Marie CurieELC0038
- 9 Feb 2015Kevin SellELC0037
- 9 Feb 2015Association For Palliative Medicine Of Great Britain And IrelandELC0036
- 9 Feb 2015British Medical AssociationELC0035
- 9 Feb 2015The Royal College Of RadiologistsELC0034
- 9 Feb 2015Hospice UkELC0033
- 9 Feb 2015On Behalf Of Greater Manchester, Lancashire And South Cumbria Strategic Clinical NetworkELC0032
- 9 Feb 2015Coordinate My CareELC0031
- 9 Feb 2015Sue Ryder Care Centre For The Study Of Supportive, Palliative And End Of Life CareELC0030
- 9 Feb 2015Deanna TennancourELC0029
- 9 Feb 2015Soul Midwives' SchoolELC0027
- 9 Feb 2015Sonia DalkinELC0026