Non-enquiry session on palliative care

RAND Europe and The Healthcare Improvement Studies Institute (THIS Institute) were pleased to submit evidence to the Health and Social Care Committee’s non-inquiry session on palliative care in England. We drew on three research papers compiled by RAND Europe and THIS Institute researchers on advance care planning, end of life treatment and care, and improving implementation of NICE recommendations in Palliative and End-of-Life Care (PEoLC).

Our research highlighted key points related to the delivery of primary care and workforce. Namely, it outlines that existing systems are not consistently well-equipped to support advance care planning for individuals nearing the end of life, and that there is a lack of safe, timely and effective co-ordination and communication between acute and community services to enable effective, informed and personalised care, including transfers of care. In terms of workforce, we highlight that non-specialist health and care staff delivering PEoLC are not sufficiently supported and trained to carry out holistic needs assessments.

Our evidence submission provides three proposals for next steps:

1. Conversations about planning end-of-life treatment and care should be initiated earlier in the care pathway.

2. Multiple types of healthcare staff are well placed to initiate such conversations, e.g. GPs, community healthcare team members, and regular hospital staff, but staff would welcome greater levels of advanced communication training; this will empower them to feel confident to initiate the conversations routinely. 

3. There is a strong appetite for a standardised record of preferences regarding end-of-life treatment and care, which can be accessed across care settings, and which has both a digital and paper interface, so that it is accessible to all.