Decision details

This report provides a position statement update on health and social care’s provision of end of life care (EOLC) in Barking and Dagenham. The report identifies areas of EOLC that require further development for consideration in the 2014/15 planning cycle.

Sharon Morrow (Chief Operating Officer, B&D CCG) introduced the report to the Board.

Helen Jenner (Corporate Director, Children’s Services) reminded the Board of the importance of end of life care (EoLC) provision for children and requested that children’s needs are considered when developing the EoLC offer locally. It was suggested that demand for hospices is outstripping capacity. Sharon Morrow confirmed that the Integrated Care Group will include children’s EoLC needs within its scope of work. 

Cllr Alexander (Cabinet Member for Crime, Justice and Communities) asked if the EoLC pathway and advanced care plans are sensitive to cultural wishes and requests, and to what degree families are involved with developing end of life options.

Anne Bristow (Corporate Director,) advised the Board that EoLC needs to recognise the difference between unexpected deaths of younger adults and death in old age, as the reaction and needs of the family will depend on the circumstances in which the person died.

Cllr Reason (Cabinet Member for Adult Services and HR) asked if the Personal Assistant and Carer training provided by West and Coe Funeral Directors would be delivered on a larger scale. Bruce Morris (Divisional Director, Adult Social Care) confirmed there are plans to roll out the training. Anne Bristow suggested that local undertakers and the community and voluntary sector are given a more prominent role in developing the local EoLC offer.

Dr Mohi (Chair, B&D CCG) highlighted that end of life plans are sometimes not followed and there is a need to address the practical reasons why this happens. Sharing the end of life plan with family members is a key issue as sometimes a person’s wishes are forgotten in emotionally fraught situations or moments of crisis. The use of ‘Do not admit’ cards was suggested along with messages in bottles as ways to raise awareness that a person has an end of life plan.

It was noted that the NHS system can sometimes work against EoLC plans as by nature people tend to seek medical intervention to preserve life, overriding previously laid plans; cultural change is therefore needed.

The Board is agreed to:

1.  Note the position statement and approve the next steps for end of life care as identified throughout the body of the report (listed in Appendix 3).

2.  Request that the Integrated Care Group develops an action plan to bring back to the Board in June 2014

Further to the recommendations in the report the Board agreed to:

3.  Establish a working group, with participation from front line practitioners, to drive forward the EoLC agenda and address the practical issues that can affect EoLC plans not being followed.