The Leadership Alliance for the Care of Dying People, made up of 21 national health and care organisations, has published this report to form a response to the recommendations set out in More Care, Less Pathway, the independent review of the Liverpool Care Pathway. It sets out the approach to caring for dying people that health and care organisations and staff caring for dying people in England should adopt in future. The approach should be applied irrespective of the place in which someone is dying: hospital, hospice, own or other home and during transfers between different setting. The Priorities for Care are that, when it is thought that a person may die within the next few days or hours..
this possibility is recognised and communicated clearly, decisions made and actions taken in accordance with the person’s needs and wishes, and these are regularly reviewed and decisions revised accordingly.
Sensitive communication takes place between staff and the dying person, and those identiied as important to them.
the dying person, and those identiied as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
the needs of families and others identiied as important to the dying person are actively explored, respected and met as far as possible.
an individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, co-ordinated and delivered with compassion.
This guide captures the latest research findings on this important and emerging area of social care. It also provides some practice examples of good work in this area. The guide is aimed at health and social care commissioners of home care services for older people with complex needs. Providers of these care services may also find it useful. It recommends:
Assessment
Commissioners should:
develop their understanding of older people with complex needs and see them as people rather than as a series of individual needs
involve older people who use services and their unpaid and paid carers in designing services
understand the particular needs of older people within their local area and look at what provision already exists in the area
establish clear and unambiguous criteria for acceptance into domiciliary care services that are designed to address unmet needs.
Planning
Commissioners should:
develop values that inspire a positive attitude to home care such as flexibility and person-centeredness
design a clear plan of how to commission integrated services to improve the outcomes that can be achieved
work together with others, involving users and unpaid carers and encouraging health and social care staff to work together too
consider a single point of entry to services
investigate the role that assistive technology can play.
Contracting
Commissioners should:
use evidence-based intervention programmes
create diversity among providers
think about how effective provision can be achieved with existing staff
make sure that staff development and training are considered in the contracting model
embed an outcomes-based approach in the contracting process
contract with clear expectations regarding quality of care
have robust contractual arrangements in place and monitor outcomes.
Monitoring
Commissioners should:
move away from task-focused to outcomes-based commissioning
develop quality monitoring methods that place older people’s views at the heart of assessing quality of care
think about the impact on carers when commissioning increases the number of care packages that people receive at home
pay attention to the extra needs of people from black and minority ethnic groups and other excluded groups.
Most of the organisational models reviewed (buddying, learning and clinical networks, partnerships and joint ventures, managerial/operational franchise, mergers, and hospital chains) could help drive improvements in the quality of NHS services.
The higher the degree of organisational change, the higher the risk that the benefits will not be delivered
Common success factors across all the different organisational models include: good working relationships; a strong and shared focus on quality improvement that can be measured; and a focus on changing organisational culture.
The skills required to lead different organisational models are often different from those required to run a successful single institution.
There is also growing consensus that a trust’s problems cannot be solved without taking a whole system solution and perspective.
This guidance explains the health scrutiny regulations and provides local authorities with advice about how to implement them to ensure that existing health services are providing effectively for local communities.
This publication explores some of the organisational options available, including how high-performing NHS organisations might support providers in difficulty.
NHS, independent, voluntary and higher education staff from South West England will come together on 7 July to have their say on how the education and training of nurses and healthcare assistants should be improved to future proof the workforce for the next 15 years.
One chance to get it right, the much-anticipated pronouncement from the Leadership Alliance for the Care of Dying People, gives everyone involved in end of life care a chance to take stock and focus on what really matters when supporting people in their last days.
In a changing environment, our choices are create the future, adapt or perish. If creating the future is the one that that we wish to follow, we are entering risky territory. But then, when things are changing, innovation might be the least risky option.
The skills we need to help cope with this risk are: experimenting, a focus on genuine human needs, and amplifying weak signals. These are all things that make it a little bit easier to find a way through – they are part of entrepreneurial judgment. They are part of inventing the future.
Post that identifies the need to get better at scanning and connecting ideas. It’s not enough just to look at what our direct competitors are doing – in fact, it might be counterproductive. Instead, we need to look into areas that face similar problems. For example, the NHS and then other health services started to learn how to work more effectively and more safely by adopting some of the methods used by Formula 1 pit crews. As Nilofer Merchant says, the social era is about connecting things, people and ideas. So you need to travel, meet people, and read. By doing these things purposefully, we can improve our scanning and connecting skills. Even if we’re introverts, we can look for experiences and ideas outside of our comfort zones.
The article discusses the accuracy of psychometric testing in predicting the performance of an employee. It discusses the case of Paul Flowers, former chairman of the Co-operative Bank, criticisms on the use of psychometric testing by hiring managers and a way to translate a test score into a meaningful outcome for a company.