I guess that for many of us over the last year we have been given time to reflect on the way our lives had been getting busier and busier. For some people, this reflective time came as an opportunity, whilst for others it was the start of a terrible and worrying time. Covid-19 and all its impact has changed us.


The Social Care Services have struggled at times over the last 10 years to make their voice heard. National Plans have been written and, in some part, implemented. They covered integrating more with health, being more efficient, cutting jobs and budgets and generally expecting the very services that are under pressure to sort themselves out. Yet for all sorts of reasons this has not happened unilaterally, and we went from implementing significant public spending cuts to “we will do all that is necessary to control this virus” during the pandemic. It might be thought that budgets seemingly had no limits now, or at least within the public perspective, but it’s not the reality for Local Authorities.


The cost of this virus cannot be measured in pounds alone, there has been a great cost to individuals, families and society in general. People have lost loved ones, friends and colleagues to Covid-19 and because of its very nature, the services that have been previously cut cannot be resurrected instantly to help manage the aftermath of such tragedy. What has been positive though is that compassionate communities have pulled together and support their neighbours and those in need, which has been great, but what is the plan for longevity and sustainability? At the same time how are long term, established and well-known charities and services going to survive let alone cope with the aftermath and fall out of this pandemic. Billions of pounds have been promised, commitments have been made but it will not be long before the day-to-day pressures of living will emerge again to consume us all.


There is no doubt that lessons will be learnt; conversations will be encouraged and planning for better personal endings will be in the forefront of people’s minds. The personal loss experienced and time to grieve for the tens of thousands who have been impacted by 2020 will be with us well into 2021 as a legacy of Covid-19.


So, 2020 has more than shone a spotlight on the importance of Palliative and End of Life Care services (PEoLC). The importance and value of such services is now being acknowledged and recognised but how do we collectively make sure that the spotlight does not burn us out or simply fade due to fatigue. In many ways the services are a community and the resilience and energy put in by many has been unprecedented. For many years we used to rehearse the saying “who cares for the carers” and how true is that today!


Many things are true and encouraging about the current situation and they should be celebrated well into 2021. Those working/volunteering in the health and social care sector from whatever perspective need more than being applauded, they need to be cherished, supported, thanked and encouraged. They need to know they are valued and appreciated. They need to be rewarded and given security in their roles. They need to have services available for them personally as the fallout takes its toll and most of all they need recognition of the importance of sustainability for all the many facets that exist in the business we call “Caring”.


New initiatives have been developed and rolled out during this time including the What Matters Conversations work that clearly demonstrate an enhancement of practice and more inclusive involvement of those who want to plan for their end of life. If you have not done so already, please check the site out. https://www.whatmattersconversations.org


Ambitions for Palliative and End of Life Care

A national framework for local action 2021-2026.


Five years ago, following considerable collaboration and formation of the Ambitions Partnership the first framework was published and a drive to embed this into practice started. Times were different then, but the energy for change started to happen. National policies changed and a clear direction of improvement in this important area of work was established.


The Partnership thrived and the campaign to improve services and attitudes gathered momentum. NHS England embraced the Partnership, and Leaders with influence in the NHSE/I established strong governance arrangements to steer and progress positive action and change.


During the last year, the workforce and organisations using the framework have been consulted and minor tweaks made to enhance the latest version. The lessons from the pandemic experience have been incorporated into the revised publication but the key essence and ambitions remain strong.


These are difficult and unprecedented times but as a collective workforce implementing the Six Ambitions have never been so important.


  1. Each person is seen as an individual
  2. Each person gets fair access to care
  3. Maximising comfort and wellbeing
  4. Care is coordinated
  5. All staff are prepared to care
  6. Each community is prepared to help


Treating people as individuals, with fair access to the care when they need it, is critical. Then ensuring they are comfortable, and their overall well-being is taken care of in a clear and coordinated way, by staff that really care, must be assured. Clearly the Community in the widest context has stepped up but part of Ambition 6 requires experienced and qualified bereavement services to be in place and resourced to meet the need that inevitably will emerge.


As we go through 2021, and as the light might be appearing at the end of the tunnel, let us spare a thought and give thanks for all paid, voluntary and family carers, young and old. Use the Ambitions Framework to make a difference and personally encourage the compassion and conversations that have emerged during the pandemic for the greater good.


A personal perspective


I have personally had time to reflect recently about why I got passionately involved over ten years ago in trying to add the social care voice to the improvement in Palliative and End of Life Care Services. It reminded me of this article that I wrote after sharing my experience at a conference. It was published around the same time as the initial Ambitions Framework. “My life, my way, with your support: George's story” described my Dads experience in 2008 and given my professional role at the time I was exasperated by the difficulties that existed.


I have concluded that there has undoubtedly been much improvement as a result of many passionate peoples work in implementing the Ambitions but there is still more to achieve. Let us collectively make sure that the Ambitions are a reality for all and that no one gets left behind.

John Powell MBE