Framework for Provision of Pain Services for Adults across the UK with cancer or life-limiting disease
This document presents a framework and operational guidance for improving pain services for adults across the UK with cancer or life-limiting disease.
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Learn more about what motivates us to advocate for our members
The Academy of Medical Royal Colleges now endorses the writing of outpatient letters directly to the patient and copying them to relevant health care professionals. This is quite a change from the tradition of writing to the HCP and copying patients. This change is in line with patient empowerment and reducing paternalism, Good Medical Practice from the GMC and the NHS Constitution. In clinical trials it was well received by patients and doctors and it improved patient centred communication.
What is your unit doing and how applicable to palliative care? Do you have experience of working this way that you can share with the membership. The APM welcomes comments on this, use the ‘Please write to me’ pdf here.
National Institute of Health and Care Excellence [2015]
• List of recommendations for adults entering the last days of life
• Includes those dying from chronic or acute diseases
• Includes recognition of dying, decision –making and symptom control
• Section on assisted hydration
• Pharmacological management of symptoms has specific recommendations for certain problems and refers to local guidance for others
• Highlights areas of research needed to provide good quality evidence
click here
Full guidance can be located here
A national framework for local action [2015-2020].
Broad partnership of national organisations with commitment to improving end of life care in England. Present overarching vision and six ambitions to use as a framework for local action.
• Each person is seen as individual
• Fair access to care
• Maximising comfort and wellbeing
• Care is coordinated
• All staff are prepared to care
• Each community is prepared to help
• The document presents a broad and far-reaching vision including changes in the publics’ perception of dying.
click here
A review of choice in End of Life Care. The Choice in End of Life Care Programme Board [2015]: London.
Government review of choice in end of life care. The recommendations include
• Individuals to be given an opportunity to specify choices and preferences
• Services available to allow choices to be supported
• Resources and training needed to enable above
click here
Investigations by the Parliamentary Health Service Ombudsman into complaints about end of life care. [2015]
• Independent investigation of complaints
• Presentation of cases highlighting issues with end of life care
• Recommendations about improving communication, recognition of dying, and symptom control
click here
A narrative for person centred coordinated care for people near the end of life. London: National Voices and the National Council for Palliative Care [NCPC] and NHS England [2015]
• Statements of end of life priorities from individuals nearing the end of life
• Discusses a range of issues including symptom control, communication and co-ordinated care
click here
Review of the evidence. Personal Social Services Research Unit, London School of Economics and Political Science and Marie Curie [2015]
• Review of literature and nationally available data
• Highlights differences due to diagnosis, region, ethnicity
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NCPC and Public Health England [2015]
• Activity and demographic data from Palliative Care teams working in different settings
• Includes workforce data
click here
Strategic Framework for Action on Palliative and End of Life Care (Scotland)
Royal College of Physicians [2015]
• Audit of case notes of all deaths in hospitals over 1-month period
• Assessed identification of dying, communication, needs assessment and symptom control
click here
Office of National Statistics [2015]
• Annual survey of bereaved people rating quality of end of life care
• Interesting responses about place of death
click here
Improving people’s experience of care in the last few days and hours of life. The Leadership Alliance for the Care of Dying People. London: LACDP. Priorities of care for dying [2014]
• Presents five priorities of care for people dying in coming days
• Provides framework for local guidelines and follows recommendations of Neuberger review of Liverpool Care Pathway
• One chance to get it right: One year on report [2015]. An overview on commitments made in in previous report-system-wide response to the Independent review of the Liverpool Care Pathway click here
Unlicensed products that are prescribed for individuals to satisfy an individual patient need are called specials. Patients often experience difficulty in either getting prescriptions or in accessing these medications due to huge variations in costs. A Specials Working Group was set up with the aim of addressing this issue. This is an inter-specialty working group representing Dermatology, Paediatrics, Ophthalmology and Palliative Medicine. The aim of this working group is for specials to be added to the Drug Tarriff. The work of the group has led to non-specific primary enabling legislation being put in place. A list of palliative care specials has been approved by the APM and can be found here.
Template letter to accompany specials prescriptions IL 25 01 18
In an effort to empower patients and improve access to their treatment, the Specials Working Group has prepared a template letter which APM members could give to their patients when they prescribe a special. It also provides a hyperlink to a list of NHS specials manufacturers (reproduced with kind permission by the British National Formulary) and other relevant online links. Additionally, the letter will inform and give the patient the possibility of contacting NHS Complaints, if access to their special is denied.