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Found 106 results
  1. Content Article
    The Care Quality Commission (CQC) were commissioned by the Department for Health and Social Care to conduct a special review of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions taken during the COVID-19 pandemic. This interim report sets out the progress of our review so far and our expectations around DNACPR.
  2. Content Article
    Sarah Scobie, Deputy Director of Research at the Nuffield Trust, looks at the continued high numbers of people dying at home, even as hospital deaths return to close-to-average levels, and discusses what reasons might lie behind the continued high numbers of home deaths since the onset of the pandemic. Whatever the reasons for the greater number of deaths at home, a third more people are now dying at home than prior to the pandemic. Although it is widely thought that many people prefer to die at home, this shift presents a significant challenge for community health and care services to deliver high quality care for patients, and to support families at the end of life. 
  3. Content Article
    Asking a simple yet powerful question: ‘what matters to you?’ can give us, as healthcare professionals, vital insights into the lives of our patients, not always captured in routine assessments. If what matters to a patient is then shared with the whole multidisciplinary team (MDT) it can ensure that ongoing support and treatment is focused around the patients’ priorities, rather than what we think is important as healthcare professionals. It becomes truly patient focused. This blog was written by Ann Bryan, a physiotherapist, and Ines Brito, an occupational therapist, both part of the therapy team working at the Marie Curie hospice in Hampstead.
  4. Content Article
    A powerful account from a daughter on the care her mum and dad received in hospital.
  5. Content Article
    The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a process supported by the Resuscitation Council (UK) and UK Royal Colleges to create personalised anticipatory care plans for patients. Hampshire Hospitals NHS Foundation Trust has been an early adopter of this process with variability in engagement with this process across our trust. Published in Progress in Palliative Care, this paper describes a quality improvement project was performed to improvement engagement with ReSPECT as well as consistency and quality of documentation.
  6. Content Article
    Critical care teams frequently have to deal with uncertainty of prognosis and outcome, simultaneously react to changing physiology with resuscitative measures, consider palliative interventions and communicate (with empathy) rapidly changing situations to patients and families during very distressing times. Shared decision-making is regarded as best practice but lack of capacity often precludes this. If more information about patients’ wishes and beliefs were available ICU teams would be better positioned to make Best Interests decisions, enabling individualised care, thereby minimising confusion and conflict due to clear communications about advance care planning.
  7. Content Article
    In this Editorial published in BMJ Quality & Safety, Major and Aphinyanaphongs discuss the challenges in translating mortality risk to the point of care. Despite advances in medicine, prognostication remains inaccurate for many patients. Physicians tend to overestimate survival, even in advanced cancer and terminal illness groups. Over half of terminally ill patients express they do not want prolonging of life if their quality of life would decline. End-of-life interventions such as advanced care planning have shown improved adherence to patient’s wishes, improvement in satisfaction and reductions in stress, anxiety and depression, but clinicians remain reluctant to initiate end-of-life discussions with terminal patients if they are currently asymptomatic. Automated systems can complement clinician judgement to prompt earlier end-of-life discussions.
  8. Content Article
    This evidence briefing from the Improvement Academy states what providers of care homes and commissioners of older peoples services should do to improve outcomes.
  9. Content Article
    This issue of Effectiveness Matters has been produced by the Centres for Review and Dissemination in collaboration with the Yorkshire and Humber AHSN and the Improvement Academy and updates a previous issue published in January 2015. Frailty is a distinct health state related to reduced function across multiple physiological systems that develops as part of the ageing process. Frailty means that even minor events can trigger disproportionate changes in health status after which the patient fails to recover to their previous level of health.
  10. Content Article
    Poster summarising the barriers in sharing learning across organisations in healthcare.
  11. Content Article
    Blog by critical care outreach sister, Claire Cox, on a typical night shift and how it led her to the Darzi Fellowship.
  12. Content Article
    Blog by the Practice Team at the Nursing Times.
  13. Content Article
    The current COVID-19 pandemic has necessitated the redeployment of NHS staff to acute-facing specialties, meaning that care of dying people is being provided by those who may not have much experience in this area. This report published by Future Healthcare Journal, details how a plan, do, study, act (PDSA) approach was taken to implementing improved, standardised multidisciplinary documentation of individualised care and review for people who are in the last hours or days of life, both before and during the COVID-19 pandemic. The documentation and training produced is subject to ongoing review via the specialist palliative care team's continuously updated hospital deaths dashboard, which evaluates the care of patients who have died in the trust. It is hoped that sharing the experiences and outcomes of this process will help other trusts to develop their own pathways and improve the care of dying people through this difficult time and beyond.
  14. Content Article
    The COVID-19 pandemic is challenging health care systems worldwide; none more so than critical and intensive care settings. Significant attention has been placed on the capacity of intensive care units (ICUs) to respond to a COVID-19 surge, particularly in relation to beds, ventilators, staffing and personal protective equipment. This position statement has been produced by the Australian College of Critical Care Nurses and the Australian College of Infection Prevention and Control (ACIPC) to guide critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the ICU.
  15. Content Article
    Helping patients and their families cope during a terminal illness is fundamental to good health care and that depends on professionals and the people in their care having access to the right information at the right time to support them. The Professional Record Standards Body (PRSB) has published the crisis care standard to support better coordination of treatment in primary,acute and community care, as well as hospices, care homes, and social services. The standard will also help patients to avoid unnecessary admissions and procedures.
  16. Content Article
    This is the second part of Irene Tuffrey-Wijne's (Professor of Intellectual Disability and Palliative Care at St Georges NHS Trust) blogs on end of life care for people with learning disabilities. This time focusing on why it is important. 'End of life care planning is not so much a question of where and how do you want to die? But where and how do you want to live until you die?'
  17. Content Article
    This is part 1 of a series of blogs on end of life care planning and people with learning disabilities. This is a tricky subject as there seems to be confusion on the language. What's the difference between an end of life plan and a funeral plan? Should these plans be for young and old - well and unwell? What does the CQC say? This blog, by Irene Tuffrey-Wijne, Professor of Intellectual Disability and Palliative Care at St Georges NHS Foundation Trust, should give you some of these answers.
  18. Content Article
    This poster has been developed by Dr Antonia Field-Smith and Dr Louise Robinson from the Palliative Care Team at West Middlesex Hospital. It provides a guide for communicating with relatives with compassion during the Covid-19 pandemic.
  19. Content Article
    This link provides a framework for end of life care and breaking bad news during the Covid-19 pandemic. It has been created by e-LfH, a Health Education England Programme in partnership with the NHS and Professional Bodies. Resources include: Discussion of Unwelcome News during Covid-19 Pandemic: a framework for health and social care professionals  Covid-19: Evidence-based advice for difficult conversations Scottish Quality and Safety Partnership Poster - unwelcome news Real Talk Framework Telephone Prompt List Real Talk Framework Sketch Note Video 1 - The framework Video 2 - Community (Advance Care Planning: how I have the conversation) Video 3 - Breaking bad news Video 4 - Ceilings of Treatment. Nb: The below link will take you to a landing page. To access the end of life resources listed above, you will need to go to the 'End of Life Care' folder and then to 'Documents and Videos'. 
  20. Content Article
    This page provides a list of useful resources for healthcare staff who are working in intensive care units and critical care roles during the COVID-19 pandemic.
  21. Content Article
    Difficult conversations are always needed in healthcare and are important in order to offer informed choice of what treatments will be of benefit to the patient and are important to manage the expectations of patients, families and clinicians. But what is currently happening during the coronavirus pandemic in primary care? What should be best practice? Claire, a clinical outreach nurse, explores this in her latest blog.
  22. Content Article
    The Talking about dying report seeks to offer advice and support for any doctor on holding conversations with patients much earlier after the diagnosis of a progressive or terminal condition, including frailty. The report identified that the timely, honest conversations about their future that patients want are not happening. Yet, these proactive discussions are fundamental to effective clinical management plans, part of being a medical professional and align with the aspirations of the Royal College of Physicians's Future Hospital Commission report. The Talking about dying report begins to highlight and challenge professional reluctance to engage in conversations with patients about uncertainty, treatment ceilings, resuscitation status and death. It offers some ‘mythbusters’ to get physicians thinking and we offer signposts to tools and educational resources to support physicians and other healthcare professionals.
  23. Content Article
    Health Education England has published a set of materials and films which aim to support staff through difficult conversations arising from the COVID-19 outbreak.
  24. Content Article
    All hospitals have access to specialist palliative care teams, whether as in-house hospital palliative care teams or in-reach teams from local palliative care services. These teams will be able to provide advice and support, but it will not be possible for them to provide direct care to everybody who needs it, especially as the pandemic progresses. This NHS guidance is aimed at all professionals looking after patients with coronavirus, and their families, in the hospital setting.
  25. Content Article
    This is a guide to end of life care symptom control when a person is dying from COVID19 for General Practice Teams, prepared by the Royal College of General Practitioners (RCGP) and the Association for Palliative Medicine.
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