investment to improve care for people coming to the end of their
lives. This follows on from the commitment in the recent Command
Paper 'Building on the Best' to take forward training programmes so
diagnosis, will have access to high quality palliative care.
There are already a number of initiatives underway to train staff
caring for patients dying of cancer, including the Gold Standards
Framework, Preferred Place of Care and Liverpool Care Pathway.
This new money will build on such programmes and ensure that more
patients are able to benefit, by widening the pool of staff who are
trained in meeting the needs of people nearing the end of their lives
and also be able to offer appropriate support to them in the setting
of their choice.
The Department of Health will be working with organisations such as
Macmillan Cancer Relief, Marie Curie Cancer Care, the Cancer Services
Collaborative, Age Concern and Help the Aged.
John Reid said: 'People with incurable illnesses should be able to
choose appropriate services that can offer them relief. They may also
want to make choices relating to the end of their life, such as where
to die. We are working towards an NHS where every patient has a choice
of when, where and how they are treated.
'Working with our partners in healthcare, including the voluntary
sector is fundamental to achieving this vision. This investment will
be used to build on and extend the excellent work already in progress
to provide appropriate specialist palliative care to patients in the
setting of their choice.'
Dame Gill Oliver, director of service development, Macmillan Cancer
Relief said: 'We welcome this additional money and the recognition of
the innovative work which Macmillan and others have already achieved.
Death for us all is a certain ty and people should be able to choose
where they die and how they wish to be cared for.
'Macmillan's Gold Standards Framework has enabled improvements for
terminally ill cancer patients which can readily be applied to all
areas of end of life care so that everyone, not just cancer patients,
benefits. If we can get it right in cancer we can get it right for
Jonathan Ellis from Help The Aged said: 'Help the Aged welcomes this
investment in palliative care services that will help to ensure that
older people are able to exercise greater choice and control at the
end of their lives.
'Being able to retain dignity at the end of life and make personal
choices about where to die are essential.'
Marie Curie Cancer Care provides palliative care to 30,000 cancer
patients each year of which half are enabled to die at home. Chief
executive, Tom Hughes-Hallett added: 'Marie Curie Cancer Care welcomes
this news. This commitment begins to provide real choice to palliative
care patients about where they chose to die and the quality of care
they receive. We see this as the first step, in an often neglected
area of care, towards making a difference to terminally ill patients
and their families. In particular we welcome the additional funding
for the Liverpool Care Pathway for the Dying.'
And Gordon Lishman, director general of Age Concern England said: 'We
welcome the Government's additional investment. Access to high-quality,
palliative care services can make an enormous difference to thousands
of older people, freeing individuals from pain.
1. This training initiative builds on a number of work strands
already in hand to develop specialist palliative care services for
adults with cancer, as well as training programmes for district
nurses. The forthcoming National Institute for Clinical Excellence,
guidance on supportive and palliative care, due to be published in
spring 04, will provide an evidence-based assessment on which to
develop general palliative care services for both cancer and non
cancer patients. Ahead of this publication the Cancer Services
Collaborative is already working in partnership with Macmillan Cancer
Relief, Marie Curie Cancer Care and Lancashire & South Cumbria Cancer
Network to support the implementation of the Gold Standards
Framework, Preferred Place of Care and Liverpool Care Pathway for the
2. Macmillan Gold Standards Framework (Macmillan Cancer Relief) The
Gold Standards Framework GSF) is currently being used by over 500 GP
practices and across 30 out of 34 cancer networks. The framework aims
to improve palliative care provided by the whole primary care team.
It enables those approaching the end of life to be identified, their
care needs assessed, and a plan of care with all relevant agencies,
put in place. The framework focuses on optimising continuity of care,
teamwork, advanced planning (including out of hours), symptom control
and patient, carer and staff support. This additional funding will
enable us to speed up the appointment of further facilitators to
support clusters of GP practices wishing to implement this framework.
3. Preferred Place of Care (Lancashire and South Cumbria Cancer
Network) The Preferred Place of Care is a tool, which enables
doctors, nurses and others to discuss with patients and their carers
their preferences around end of life care so that they are able to
make informed choices. The tool also invites the patient and carers
to comment on their experience of care, thereby including users in
the development of service provision. The additional funding will
enable this tool to be rolled out nationally.
4. Liverpool Care Pathway for the Dying (Marie Curie Cancer Care)
This tool assists the doctors, nurses and others to deliver high
quality care as the end of life approaches. Although primarily
designed for cancer patients it is i ncreasingly used by staff working
with older people dying from a range of other conditions. The tool
enables the best of hospice care to be transferred into other
healthcare settings, including hospitals, the community and care
homes - the additional funding will enable us to speed up this
The recent Command Paper 'Building on the Best' is available here.