Quality statement 10: Specialist palliative care

Quality statement

People approaching the end of life who may benefit from specialist palliative care, are offered this care in a timely way appropriate to their needs and preferences, at any time of day or night.

Quality measure

Measures from End of life care strategy: quality markers and measures for end of life care (Department of Health 2009).

See also quality measures and national indicators for further information.

Outcome: See the overview for overarching outcomes.

What the quality statement means for each audience

Service providers ensure that systems are in place (such as shift patterns and on-call rotas), to provide timely specialist palliative care and advice at any time of day and night for people approaching the end of life who may benefit from specialist input. Care should be appropriate to the person's needs and preferences.

Health and social care professionals provide timely specialist palliative care and advice at any time of day or night for people approaching the end of life who may benefit from it, or know who to contact for specialist palliative care and advice. Care should be appropriate to the person's needs and preferences.

Commissioners ensure they commission specialist palliative care services with sufficient provision and capacity to provide timely specialist palliative care and advice at any time of day and night for people approaching the end of life who may benefit from specialist input. Care should be appropriate to their needs and preferences.

People approaching the end of life are offered specialist palliative care if their usual care team are unable to relieve their symptoms adequately. It is offered at the right time for them and is appropriate to their needs and preferences at any time of day or night.

Source guidance

Department of Health quality markers and measures for end of life care top ten quality markers for providers 7; and markers and measures 1.22, 1.23, 1.27, 3.2, 6.7, 6.8, 7.2, 7.3, 7.4, 7.5, 7.6 and 10.4.

Data source

Process: Local data collection. The draft End of life care locality register pilot programme comprehensive dataset from the Information Standards Board records whether the person is known to a specialist palliative care team.

The National Council for Palliative Care collects activity data on specialist palliative care services via the minimum data set (MDS) for Specialist Palliative Care Services.

Definitions

Specialist palliative care encompasses hospice care (including inpatient hospice, day hospice, hospice at home) as well as a range of other specialist advice, support and care such as that provided by hospital palliative care teams. Specialist palliative care should be available on the basis of need, not diagnosis.

'People who may benefit from specialist palliative care' are those whose symptoms cannot be managed in a timely way by their usual care team.

The following minimum recommended service levels have been adapted from NICE cancer service guidance and the Department of Health quality markers.

Specialist palliative care inpatient facilities should be responsive to emergency need and able to admit people approaching the end of life at any time of day or night.

Palliative care services should ensure provision to:

  • Visit and assess people approaching the end of life face-to-face in any setting between 09.00 and 17.00, 7 days a week (provision for bed-side consultations outside these hours is high-quality care).

  • Provide specialist palliative care advice at any time of day or night, which may include telephone advice.

Specialist palliative care, including assessment and advice, may be provided by physicians in palliative medicine or other suitably trained practitioners, such as clinical nurse specialists in palliative care. Qualified district nurses – 'specialist community practitioners in home nursing' – may or may not have an appropriate level of education in specialist palliative care. Social workers, occupational therapists, physiotherapists and other therapists may also have specialist skills in palliative care.