Blog by Dr Liz Nuttall, North West Surrey End of Life Care Lead

We all know the importance of good end of life care and of course we only have one chance to get it right.

The End of Life Care Team across Surrey Heartlands has been examining how we can develop seamless collaborative care for end of life patients across our Integrated Care System (ICS). In doing this, we can also better support cohesive shared decision-making for patients with life limiting illnesses (ie those in their last year of life).

Until now, end of life care has been isolated, although of course it is important to a number of work streams such as cancer, diabetes, children, dementia, digital and medicine optimisation.

I recently presented to colleagues at the Surrey Heartlands Academy Clinical Forum about how, working together across Surrey Heartlands, we can do even more to provide high quality end of life care for patients.

Changing patient’s perceptions of hospices, for instance, is one thing that we can easily do and is something that can have huge benefits.

Take the example of Annabelle. She has been a patient at one of our hospitals for more than 20 years, and her condition, Chronic Obstructive Pulmonary Disorder (COPD), has worsened over that time.

During a routine visit, one of the nurses suggested to Annabelle that she might benefit from end of life care through a hospice.

Annabelle was initially very apprehensive about going to a hospice when she wasn’t in her last days of life. “I’m not ready for a hospice,” she said. “In my mind you go to a hospice to die. Well, how wrong I was.”

Through the hospice she and her family were able to get appropriate help and support, including wellbeing and rehabilitative groups, emotional and spiritual support, complementary therapy, continued symptom monitoring and medical advice to help her to get the most out of the remainder of her life.

Other things that we can do are to make sure that End of Life Care has clear links into all of our work streams, share existing good practice, standardise the way the end of life process is delivered and have conversations early on with families.

Next month, the End of Life Care leads for Surrey Heartlands, local hospices and social care and palliative care consultants will meet to plan how we’re going to develop seamless, collaborative care for end of life patients across the ICS. We’ll be taking ideas back to a future Academy Clinical Forum meeting and I look forward to sharing these with you.