Across London, there is considerable variation in the patient experience, provision of services and whole system costs associated with palliative/end of life care.

Compared to national figures, there are still high numbers of people dying in hospital, irrespective of diagnosis and those in the last three months of life in many London CCGs are more likely to experience three or more emergency hospital admissions than in other parts of the country.

The RM Partners palliative care group has produced two reports – Seven day Specialist Palliative Care Provision across London and Enhanced End of Life Care in the Community, that provide a clear accurate picture of current provision matched with likely population need. From that work the group was able to derive an options appraisal along with recommendation for both face-to-face specialist palliative care in all settings and for enhanced community end of life care provision.

The need for specialist palliative care (SPC) advice, assessment and support out of normal working hours has long been recognised. As far back as 2004, this service was identified as a minimum standard and the need has been reiterated in many policy documents since then. Patients require specialist palliative care every day and not just Monday to Friday. Despite this, provision in London, both in hospital and the community has been limited.

With regard to end of life care, local community/ district nursing services have in recent years struggled to manage the needs of increasingly dependent patients in their own homes. In some areas enhanced community end of life care (EoLC) services have developed which can allow more patients to remain at home until they die but there is not equitable availability of such services.

The group undertook an evidence review and mapped current services and availability across London. The results informed the production of templates that providers can use to produce a local business case for their commissioners.

For further information contact Maureen McGinn, Senior Project Manager at: maureen.mcginn@nhs.net

Seven Day Specialist Palliative Care Provision Across London June 2018

SPC business case template June 2018

Enhanced End of Life Care in the Community August 2018

End of Life Care business case template August 2018