MS, Cabinet Secretary for
Health and Social Care: Good palliative and end-of-life care
can make a real difference to the quality of life for people with
a life-limiting illness. It is why we invest more than £11m every
year in these services and why improving palliative and
end-of-life care is a Programme for Government commitment.
Person-centred care is at the heart of our vision for palliative
and end-of-life care – we believe that everyone who needs it,
should have access to the best possible care in Wales.
The national palliative and end-of-Life care programme provides
national leadership and acts as a forum to drive change and
improvement in services across Wales. The quality statement for
palliative and end-of-life care sets the strategic direction and
the ambitious standards needed to deliver the outcomes and
experiences we expect for everyone accessing such care.
We have achieved a lot since May 2021. The national programme's
core team has been expanded to include additional medical,
nursing and allied health profession expertise; a strategic
programme lead has been appointed and a series of stakeholder
advisory groups have been set up to support the ambitious work
programme. This includes representation from people with lived
experience and our voluntary hospices in Wales.
We recognise the significant financial challenges hospices are
facing and are committed to working with them and the national
programme board to find a sustainable funding settlement. This
includes developing a hospice commissioning framework for Wales.
This work is being taken forward by the national programme board
with support from the NHS Wales Joint Commissiong
Committee.
We have delivered on the first phase of our commitment to review
voluntary hospice funding and provided an additional £2.2m for
hospices on a recurrent basis from April 2022. Phase two
recommendations to increase the capacity of district nursing out
of hours and community clinical nurse specialists at weekend and
on bank holidays are being implemented through our Further Faster
programme.
The interim phase three recommendations were received in
February; as part of our response, we provided the 12
NHS-commissioned hospices with a £4m cost-of-living grant to
support delivery of their vital services.
Under the guidance of the advance and future care planning group,
we have strengthened the DNACPR and advance care planning
resources. We review and update Sharing and Involving –
the DNACPR policy for adults in Wales – every two years to
reflect evidence-based practice and have developed an all-Wales
DNACPR competency framework for nurses and allied health
professionals and an information leaflet for individuals and
carers to help make decisions about CPR clearer.
We have made significant investments in bereavement services and
have undertaken work to improve bereavement care. This includes
the publication of our national bereavement framework in October
2021 and the launch of a specific bereavement pathway to support
people affected by the sudden or traumatic death of a young
person up to 25. Bereavement pathways for children and young
people and pregnancy and baby loss are progressing well. We have
extended the £3m bereavement support grant to third sector
organisations for a further three years to 2028 and have provided
an extra £420k to health boards to strengthen bereavement
co-ordination.
Our ambition is to recruit and retain a motivated and skilled
palliative and end-of-life care workforce. Modelling and data
analysis work is ongoing to predict future costs and workforce
need and the national programme team is working with Health
Education and Improvement Wales to develop a palliative and
end-of-life care competency framework.
Work is ongoing to develop a national service specification for
palliative and end-of-life care to provide guidance on achieving
the highest standard of care in Wales. This will define the
out-of-hours service, the specialist palliative care service and
scope the referral criteria across the different sectors and
health boards. Work is also underway to develop a medium-term
plan for palliative and end-of-life care that will focus in part
on the wider education and support for unpaid carers.
While significant progress has been made, we know that challenges
remain including disparities in the availability and quality of
palliative care services in parts of Wales; workforce shortages
and the lack of comprehensive data about patient outcomes and
experience.
Under the leadership of the national programme board, we will
continue focus on person-centred care as we to continue to
improve palliative and end-of-life care.
