End-of-life care in the UK has been ranked as the best in the world with a recent study praising the quality and availability of services available. The recent report by the Economist Intelligence Unit in its ‘Quality of Death Index’ reviewed both NHS and hospice care and the UK scored 93.9 out of 100 across 80 countries [i].

The Report author Annie Pannelay said: "The UK is an acknowledged leader in palliative care. That reflects its comprehensive strategy towards the issue as well as the improvements that are being made.

"But there is more that the UK could do to stay at the forefront of palliative care standards, such as ironing out occasional problems with communication or symptom control."

Skills for Health has assisted several organisations in both the NHS, as well as hospices, over the past few years to improve and build upon the level of care they provide in their palliative care services.

Worcestershire End of Life Care

As part of a range of measures to improve services to patients, South Worcestershire Clinical Commissioning Group recently commissioned Skills for Health to carry out a workforce skills review across the CCGs in Worcestershire to assess whether frontline services across the county met the requirements of the Department of Health’s End of Life Care Strategy (EoLC).

The challenge

The EoLC Strategy states that wherever possible people should be able to spend their last days in the place of their choosing. This has led to an increasing number of people who say they would prefer to get this support in their own home.

The CCGs wanted to ensure that all integrated staff teams across the county had the skills and training to meet this challenge, and asked Skills for Health, to review their workforce’s skills. The review included health and care trusts (specifically the Integrated Community Teams) along with other staff delivering EoLC services, including social care colleagues and hospice staff.

The aims were to assess the current competences and identify future competences required for EoLC Services across the county; to identify any skills gaps; and to develop a competence framework for the workforces that provide those services.

“Skills for Health have been very supportive throughout the process of workforce planning and responsive to our needs and wishes. They have provided us with detailed reports as per the specification. They are willing to go the extra mile to ensure we are satisfied with the quality and content of reports.” Debbie Westwood
Senior Programme Lead, South Worcestershire Clinical Commissioning Group

Skills for Health made a number of recommendations to the three CCGs in Worcestershire as a result of the review, including:

advanced communications training for all those involved in EoLC, to help them deliver sometimes difficult messages to patients, their carers and families more regular, scheduled clinical supervision for community staff, to allow them to talk about what can be difficult and challenging experiences training in assessing the cultural and spiritual needs of patients nearing the end of their life, as well as facilitating care after death, because many staff felt unsure of how to do this future HR and personnel practice for EoLC staff to be underpinned by the Skills For Health Role Templates and associated competences that specify the required skills and knowledge to deliver quality EoLC in the community.

As a direct result of the analysis and review, South Worcestershire CCG is assessing existing training across the county to ensure it reflects the EoLC findings, meets current staff needs and is targeted at the most appropriate staff. It is also looking into other training requirements.

The CCGs are working with partners to assess other findings to ensure they continually review quality of care in meeting the growing EoLC challenge.

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[i] Quality of Death Index, Economist Intelligence Unit, 2015, http://www.economistinsights.com/healthcare/analysis/quality-death-index-2015

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