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Good practice guide

Palliative care services

The checklist below sets out some high-level statements about palliative care based on issues raised in this report. Boards (with their CHPs, voluntary sector and council partners) should assess themselves against each of the statements and consider which statement most accurately reflects their current situation:

  • not in place and action needed not in place but action in hand in place but needs improving in place and working well.
  • This approach will enable boards to identify what actions need to be taken forward.

Checklist

  • Are there agreed protocols in place (based on need, not diagnosis) for referring primary care, care home, and acute care patients with specialist palliative care needs to specialist palliative care services?
  • Are consistent assessment criteria for all patients with life-limiting conditions used to support decisions about who goes onto a GP palliative care register?
  • Do all patients on palliative care registers have an individual needs assessment and a coordinated care plan in place?
  • Is information on ethnicity, social demography, age and religion of palliative care patients recorded for all patients in boards and hospices?
    Is this monitored and action taken to promote equal access?
  • Are IT systems in place that share information across providers (including out of hours) to ensure joined-up delivery of palliative care services?
  • Has the provision of psychological, social, emotional, spiritual and respite care been assessed against the needs of palliative care patients and their families?
  • Are plans in place to address any gaps in provision?
  • Has an up-to-date palliative care needs assessment been carried out?
  • Is this used as part of a palliative care strategy to plan and deliver palliative care services?
  • Is performance information monitored to assess progress against the strategy and improve services?
  • Are user views gathered regularly and used to improve services?
  • Do NHS specialist palliative care services ensure value for money?
    • Do you have arrangements to monitor use of resources and occupancy rates?
    • Do you benchmark your services against other providers?
  • Is an agreed contract in place which specifies services and costs?
  • Does the board ensure value for money in the specialist palliative care services it commissions from other providers?
    • Is an agreed contract in place which specifies services and costs?
    • Are services regularly monitored?
  • Are referral protocols being used to link long-term conditions management, palliative care and end of life care? These should:
    • identify needs
    • ensure appropriate referrals
    • provide appropriate care.
  • Are service improvement initiatives consistently applied in all care settings (acute hospitals, community hospitals, hospices and care homes)?
    • GSFS
    • LCP
    • DNAR
  • Are arrangements in place to ensure that staff providing general palliative care have appropriate training?
  • Is there sustainable training to support general palliative care?
  • Is the board dependent on short- term funding from the voluntary sector to provide training?
  • Does each CHP have:
    • a palliative care action plan?
    • clear management arrangements for palliative care?
    • active involvement from NHS boards, the voluntary sector and councils in the joint planning of palliative care?

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