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End of life care: We must combine guidelines with mandatory training.

As NICE release their proposed guidelines for the care of dying adults, our CEO and Director of Quality and Care call for mandatory training in end of life care...
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While we know much of the media commentary commends hospices for their implementation of the now disbanded Liverpool Care Pathway, we also know there has been plenty of negative publicity too. 

So the headline from a national paper 'NHS forced to remind doctors and nurses that they must give water to the dying' - in response to today's proposed guidelines for the care of dying adults - illustrates that the effects from the press scrutiny of the Liverpool Care Pathway are still lingering. 

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Yes, this is the most negative we've seen, but in the light of the criticisms of the National Institute of Health and Care Excellence's guidelines, we'd like to tell you where we stand. It won't surprise you to know that this is something about which we care deeply. 

We welcome any guidance that helps to deliver high quality end of life care. Staff across all areas of health and social care must be empowered with both the knowledge and confidence in their ability to care for dying, to the standard that both we and families expect. These guidelines are an important part of that process. 

We applaud NICE's focus on communication and shared decision making. Partnership is a must, between the person at the end of life, those important to them and all involved with the care delivery.  We must step away from ticking boxes and focus on the person in front of us - something we know makes a big difference to both the person and those they love. 

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Relevant information must be relayed openly, so that those closely linked to the patient are involved and supported in making difficult decisions. It's also important that we don't foster hope or give false impressions about the severity of the person's condition and of their prospects. It doesn't help anyone. We're pleased that this has all been addressed in the guidelines. 

In addition to NICE's guidelines, we also call for further commitment to staff training. End of life care training should be mandatory across all health and social care arenas, not just specialist services. Why? It works in union. 

At Saint Francis Hospice - and across the hospice movement - a holistic approach to the care of our patients is fundamental. That means looking after both the person in our care and everyone connected to them, taking into consideration their physical, emotional and spiritual symptoms. For example, our social workers in the family support team can mediate and help individuals with telling their children about the fact they will die soon. We are lucky that, due to the tireless fundraising of our community, we are able to have a dedicated and adequately sized team of nurses, able to spend the time required to support those under our care through end of life. 

Crucially, our nurses and front line staff are experts in their field. They know the guidelines, but they also know how it works, in practice. 

So that's why hospices play a vital role in educating our colleagues in the health sector on end of life care provision. Our Education Centre hosts a range of courses all year round for health and social care professionals - starting from an Introduction of Palliative Care to more specific topics such as communication for administration staff or networking opportunities for nurses. They're all delivered by experts; people who've faced the challenges of end of life care and are passionate about spreading their knowledge and enhancing the care delivered and received. 

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We will also continue to advocate the importance of quality end of life care across the board. We only have one chance to get end of life care right, so it's wrong to criticise and fail to recognise steps within our health and social care service to improve the way we look after the dying. Combined with the right training, we're confident that we can consign the failings of recent years to the past. 
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