End of life care

Planning palliative care

People are generally defined as ‘approaching the end of life’ when they are likely to die within the next 12 months. This includes people whose death is imminent and expected within a few hours or days; and those with advanced, progressive, incurable conditions; and general frailty with co-existing conditions. (General Medical Council 2010).

In Bromley we currently commission end of life services from local organisations such as St Christopher’s and Marie Curie.

Giving people more control over palliative care

You can read about our plans for improving end of life care and developing a more coordinated approach in Bromley here End of life [final doc]. This document sets out our vision for helping people as they approach the end of their life to die in their preferred place in a supported, safe and appropriate environment that meets the needs they (and their loved ones and carers) have identified in advance. We believe this should be irrespective of their medical condition.

Care management and care plans

Care planning for patients approaching End of Life is done both through Coordinate My Care (CMC) and by GPs.

Co-ordinate My Care is the national solution for recording the end-of-life preferences of patients. Co-ordinate My Care is in use across all CCGs in South East London and has recently been re-launched following upgrades to the system.

Nationally – a number of key benefits have been identified including:

  • Urgent care planning helps  to prevent crises  and  distress
  • Confidence that the information documented can always be accessed 24/7 by those services that may be called  upon to provide  emergency advice  and  care
  • 79% of patients with a CMC plan whom have died, have died in their place of choice
  • Where patients have a CMC care  plan 17% die in hospital; nationally  54% die in hospital[1]

[1]  National End of Life Care  Intelligence Network, NEOLCIN, 2008-10

The system has not yet been fully endorsed by Bromley CCG but we have been regularly raising awareness among our GPs about the improvements made and the schedule of dates from when practices can gain access to the new system.

Our vision is for CMC to be installed and in use in all GP practices across Bromley leading to a higher proportion of GPs playing an active role in creating and updating CMC care plans.

In the coming months we hope to be in a position to fully endorse and widely promote the use of CMC across our local GP practices.

Learn more about care for people reaching the end of their lives, read the latest guidance on end of life care (2010) on the General Medical Council’s website.

NHS Bromley CCG, Global House, 10 Station Approach, Bromley, BR2 7EH

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