Cancer Reform Strategy - NHS Cancer Screening Programmes

102 CANCER REFORM STRATEGY7.49 The government has put in place anumber of initiatives to improve the provision ofend of life care. This has included publication ofNICE Guidance on supportive and palliative care(2004) and the funding of the NHS End of LifeCare Programme (2004-07). In June 2006, thegovernment announced that it would developan end of life care strategy which would coveradults dying from all conditions and in allsettings. The overall aims of this strategy will beto improve the quality of care for all peopleapproaching the end of their lives and to enablemore people to die in the place of their choice.A comparable strategy for end of life care inchildren is also in development.7.50 The End of Life Care Strategy is beingdeveloped in parallel with work beingundertaken by SHAs on end of life care aspart of the NHS Next Stage Review. It isenvisaged that the End of Life CareStrategy will be published alongside thefinal report of the NHS Next Stage Reviewin Summer 2008.7.51 In the interim PCTs will wish to applythe learning gained from the operatingframework 2007/08 baseline reviews ofend of life care services, to influencecommissioning decisions in 2008/09.7.52 Strategic Health Authorities will wishto ensure that emerging themes from theNHS Next Stage Review are captured andacted upon. Examples of good practice fromthe Department of Health funded End ofLife Care Programme have recently beenpublished (Making Change Happen).These cover developments in hospitals,the community and care homes. Interestingnew evidence on the cost effectiveness ofa new service model has recently beenpublished by Marie Curie Cancer Care(see Box 40).Box 40: Marie Curie Delivering Choice ProgrammeBoston in Lincolnshire is the first place in the UK to have fully implemented the Marie CurieDelivering Choice Programme, with the NHS, Social Care and the voluntary sector all working inpartnership.A range of interventions was put in place over a three year period to deliver better end of lifecare for patients in their place of choice and improved support for carers.Serving a population of 150,000, three interventions have been found to be particularlyeffective:●●●Rapid Response Team – provides crisis and planned home care;Discharge Community Liaison Nurses – facilitate discharge of end of life patients fromhospital and provide continuity of care between hospital and community; andCoordination Centre – arranges packages of home care for palliative patients through alllocal agencies and providers.As a result of this innovation:● Deaths at home have risen from 17% to 42%;●Deaths in hospital have fallen from 63% to 45%; and● Total costs for end of life care have decreased by 8%.