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Health secretary John Reid today has announced an additional£12m ...
Health secretary John Reid today has announced an additional£12m

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

that all adult patients nearing the end of life, regardless of their

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

Dying tools.

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.

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