John Powell gives an update on his work as End of Life Care Lead...

As I started to prepare my presentation for the National Hospice at Home Association Annual Conference in September 2016, I began to reflect on the last four years and how Adult Social Care has contributed to improving people’s end of life experience.

The journey so far

Within London, the turning point came when London ADASS agreed to make End of Life Care (EoLC) a priority work-stream in its 2012/13 programme. The EoLC network was born in February 2014 and the impact of its work was soon felt by people across the health and social care workforce. In a short space of time a fresh awareness had arisen about the way that we support individuals (and their family and friends) at the end of their lives.

A multidisciplinary social movement gained momentum with the formation of the Pan London EoLC Alliance. Jointly chaired by London ADASS and Marie Curie, annual conferences have brought together staff across all disciplines to discuss the benefits of collaboration and joint working. Service user representatives, specialist professionals and the collective workforce have been given the opportunity to share stories of people who have died. Positive end of life experiences are juxtaposed with more difficult approaches to death, a reminder of the gaps in quality provision which equate to a post code lottery when it comes to access.

The credibility of the Pan London Partnership has steadily grown over the past three years and an awareness of end of life considerations has spread throughout adult social care. A number of work-streams have been influenced, including the Greater London Authority review on EoLC and the development of EoLC as a commissioning priority within the new NHS Sustainability and Transformation Plans (STPs).

Great steps have also been made outside London. Ambitions for Palliative and End of Life Care is a key document which sets out a framework for local action. It was created through the collaborative work of a significant number of national voluntary sector organisations, an initiative led by Dr Bee Wee, National Clinical Director for End of Life Care and jointly chaired by Dr Jane Collins, CEO of Marie Curie. ADASS was also invited to join the partnership and this was the basis of my national role as policy lead for EoLC.

Moving forward

Adult social care now has an undeniable role in the discussion about EoLC and its improvement programme. We have left what was once a traditionally medical domain to take full advantage of the disciplines and services available. By 2015 all Directors of Adult Social Services in London had signed a Charter making affirmations about their responsibilities regarding End of Life Care. To cement this commitment it felt right to connect ADASS colleagues across the country to find out what work had been undertaken to best serve those approaching death.

In February 2016 an introductory event took place in London for regional representatives to speak about best practice and discover ways of working more collaboratively. Dr Bee Wee and Lyn Romeo, Chief Social Worker for England, were available to drive discussion which has led to the early stages of a regional work programme.

Key themes

  • Communication channels are necessary for professionals to share good practice and seek support with difficult issues and to promote new ways of working
  • We must maximise opportunities for Health & Wellbeing Boards in each locality to pursue collaborative working
  • Local STPs must include EoLC priorities
  • We must enable connections with national initiatives and provide a vehicle to contribute to the broader discussion

Achievements to date

  • Developed a London Forum for debate and exchange of information
  • Developed a suite of short films that staff can use within training sessions
  • Developed and now benchmarking against the Charter for EoLC that sets out expectations of local authorities
  • Continued contribution to national agenda and formation of the Ambitions document