End of life and palliative care toolkit
Toolkit for healthcare professionals to support patients nearing the end of life to live well until they die.
As a patient nears the end of life, a holistic approach is recommended. This approach involves early identification of those likely to be in the last few months of life, discussion of end of life issues with patients and those close to them and provision of high quality care. The process continues after death with support for those left behind as well as reflective practice and audit for the practice team.
In this section:
- Current policy best practice
- Clinical treatment guidance
- Communicating with patients and those close to them
- Current knowledge sources
- Quality Improvement
Current policy best practice
The following resources may be used to determine if a patient is nearing the end of life, and give recommendations of how treatment should be tailored to their specific requirements.
- RCGP Personalised Care Planning (185 KB PDF) - The general principles for palliative and end of life care
- Top Tips for GPs and Primary Care Clinicians The Last Day of Life (254 KB PDF), based on NICE guidance 'Care of dying adults in the last days of life' (NG31)
- Macmillan Top Tips Guide to supportive and palliative care meetings (1.3 MB PDF)
- The Golden Standard Framework (GSF) Proactive Identification Guidance provides trigger questions and guidance for initiating end of life support
- Supportive and Palliative Care Indicator Tool is a guide to identifying people with one or more advanced conditions, deteriorating health and at risk of dying for assessment and care planning
- The RCN and RCGP End of Life Care Patient Charter (330 KB PDF) lists the key points GPs should communicate to their patients
- Holistic needs assessment for patients (formerly known as the SPARC tool)
- Discussion paper about helping GPs to identify end of life patients and plan ahead (198 KB PDF)
- Implementing the RCGP and RCN patient charter (1.7 MB PDF) (clinical resources and guidance for practices)
- Scottish best practice: End of Life guidance and Building on Progress.
Clinical treatment guidance
The following resources provide best practice guidance for clinical treatment of a patient nearing the end of life.
- Palliativedrugs.com provides essential independent information for health professionals about drugs used in palliative and hospice care
- SIGN Guidance regarding control of pain for adults with cancer
- Paediatric Palliative Medicine Formulary Dosing information to support prescribing in paediatric palliative care
- Basic symptom control in paediatric palliative care A key clinical tool for treating a wide range of symptoms experienced by children with life-limiting conditions
- Palliative Care Guidelines developed by a collaboration of UK Cancer networks, and the Welsh Palliative Care Implementation Group
- Scottish Palliative Care Guidelines.
Communicating with patients and those close to them
Current legislation promotes frequent detailed communication between healthcare professionals and patients, their families and others. These tools may be used to communicate with your patients and their support network.
- Top Tips Communication skills for GPs (330 KB PDF) - Communication skills are crucial for effective care planning and avoiding complaints at the end of life
- Resuscitation Council UK guidelines on completing a DNACPR form
- DNACPR form for Wales
- Shared decision making discussion paper
- Working with informal carers: How GPs can improve the quality of life for informal carers.
Current knowledge sources
Legislation and knowledge relating to end of life processes is often changing. The following resources provide ongoing forums and updates in which healthcare professionals may keep abreast of current knowledge.
- Register to receive monthly Transforming EoL newsletter
- National End of Life Care Intelligence Network email alerts
- Palliative Care Wales
Quality Improvement
To access shared learning networks to assist you in applying practical QI methodologies to better treat this clinical area, join our QI Ready platform.