• 17Dec

    New guidelines put patient and shared decision making at centre of end of life care

    NICE has launched the first guidelines for the NHS on improving care for people who are in their last days of life. The guidelines aim to put the dying person at the heart of decisions about their care, so that they can be supported in their final days according to their wishes.

    Around 500,000 people die each year in the UK. Of these deaths 75% are not sudden, but expected.

    While a recent report has ranked end of life care in the UK as the best in the world, there are areas where care can be improved and made more consistent.

    Until recently, the Liverpool Care Pathway (LCP) was used to provide good end of life care.  It was withdrawn however, following widespread criticism and a subsequent government review that found failings in several areas. NICE was subsequently asked to develop evidence-based guidelines on care of the dying adult.

    Earlier this year the Parliamentary Health Service Ombudsman highlighted that poor communication was an important aspect in complaints over care at the end of life.

    The report said that healthcare professionals do not always have open and honest conversations with family members and carers that are necessary for them to understand the severity of the situation and the choices they will have to make.

    Consequently, NICE recommends the dying person, and those important to them should be given accurate information about their prognosis, an opportunity to talk through fears and anxieties, information about how to contact members of their care team, and opportunities for further discussion.

    Further recommendations cover individualised care, providing individual care plans, and ensuring that shared decision making is supported by experienced staff.

    Professor Sam Ahmedzai, Emeritus Professor of palliative medicine and chair of the guideline development group, said “Until now we have never had guidelines in this country on how to look after people at the end of life. This evidence-based guideline provides a good overview of how to give good end of life care in any setting in the NHS. “

    He added: “The main way this guideline differs to the LCP is that it stresses an individualised approach rather than a ‘blanket’ method of using the LCP in an unthinking way. The guideline also stresses that the patient should be reviewed daily, and the person should always be taken as an individual.”

    You can find more details and access the guideline of the NICE website here.