Agenda item

The Panel received a presentation and report from the Head of Strategy and Delivery-Community Services NHS Doncaster CCG which provided Members with the opportunity to have an overview and to consider End of Life Care. It was reported that care as someone approaches their end of life matters to everyone. The first national End of Life Strategy (2008) identified three key insights as follows:-

(1)          people didn’t die in their place of choice;

(2)          that services need to be scaled up to be prepared to support people dying; and

(3)          not everybody received high quality of care.

Members were advised that the strategy generated significant momentum and energy which had led to significant improvements in end of life care. Since that time national guidance further highlighted the principles for ensuring a health and social care system wide approach to improving the care for all residents.

It was noted that the CCG direction of travel was based on the progress of discussions both internally and with stakeholders, patient stories, what data is telling us and the best available evidence on models of end of life care.

Members were presented with progress to date which highlighted that end of life care was a priority area for the CCG and clinical leadership comes from the CCG Board Member. She stated that some of the performance indicators had been aligned with a method called CQUIN which will support joint working. However performance information had been limited. It was further highlighted that the service developments within the following areas:-

·         Woodfield 24;

·         Community Nursing;

·         Specialist palliative care inc Hospice;

·         Community equipment; and

·         Assess to medicine.

In addition, it was reported that within education and training, the CCG had funded through GP practices a gold standard framework and 63% had taken up the offer of training and Doncaster Royal Infirmary/RDaSH were to undertake training of all relevant staff in their 123 approach.

Following the presentation Members were afforded the opportunity to make comments and ask questions as follows:-

In response to whether there would be a cost associated with the use of Woodfield 24, it was reported that when a patient reaches 3 months before death it becomes a health cost would not be charged to the client. It was noted that the district nurse would act on behalf of the individual and work closely with Woodfield 24 and the family to agree a care plan. Members were advised that this process provides a much more flexible approach and more value for money.

A Member was passionate about and wished to raise an issue that had not been mentioned, which was approaching a funeral director following the death of a family member which can be very distressing. He suggested that although this was a commercial issue it may be useful to include a recognised local firm for simpler funerals. It was reported that although this had not be raised in consultations a strategic approach could be undertaken to provide an easy guide of what to ask for.

The Panel noted that not all people have the same pre-planning in place for their death and there was a debate to be had. It was clear that dying well with dignity was a fundamental conversation that happens too late. It was noted that the Council do have those difficult conversations where a person has no relatives and their repressed wish was in will form.

            RESOLVED that the presentation and report be noted.