End of Life and Palliative Care in England: Getting it right

As Programme Lead at West Midlands Strategic Clinical Networks and Clinical Senate, Laura Tooley highlights national guidance and invites us to consider our role in this emotive yet important area of care.

It seems a long time ago now that the 2008 End of Life Care Strategy (DH) was published.

Seven years on we have crucial Department of Health guidance which highlights five very important priorities for care of the dying person. ‘The approach should be applied irrespective of the place in which someone is dying: hospital, hospice, own or other home and during transfers between different settings’. (One Chance to Get It Right, 2014).

NHS England also has ‘ambitious plans to improve the care for people of all ages; people living with and dying from all conditions and those that need additional specialist help and advice’. (Actions for End of Life Care: 2014-16, NHS England).

I have worked in healthcare for 27 years in many varied roles, as a nurse, manager and leader. I’ve also been a patient. I know that we can only work towards these ambitions if we think and work together, and consider what we can all do to contribute to this collective effort.

Like many people, I am passionate about this topic. I believe that the care shown to those living with life-limiting illness, those who are dying and the people that are important to them gives us all a fair ‘temperature check’ of our health and social care system and society.

We are all going to die – I want my health and social care teams to be ready to look after me well when it’s my time.

We’re all busy, and it’s a big ask to expect more of you, but we’ve had this courageous level of collaboration role-modelled to us by the 21 members of the Leadership Alliance for the Care of Dying People. If you’re not sure what all of those members have been up to since last summer, ask one of the organisations that most closely aligns with your role.

People living their lives and yet facing death are seen in our community services, our GP surgeries, our hospitals, hospices and our urgent care settings. Also, surprising to some, in our cinemas, parks, libraries and other places where every-day living occurs. Many people are still benefitting from active treatment and support, the expertise that you might provide. However, we know that in the last year, months and days of people’s lives, their need for care can change rapidly and unpredictably.

I invite you to do three things:

  • Consider where your role brings you into contact with people who may die during the year ahead.
  • Grab a copy of One Chance to Get It Right (2014), and take a quick look – don’t be daunted by its size as it’s mostly appendices and the first pages are a good start – it really is a great read!
  • Get or stay involved; think about something that resonates in your work – something, however small that you can do – if you’re doing it already, please share it with someone new.

Strategic Clinical Networks in England have been supporting the National Clinical Director, Dr Bee Wee, with this important work – get in touch with your local network or explore the following links to find out more:

Laura Tooley

Laura Tooley brings 27 years of healthcare experience to her current NHS England role of Quality Improvement Programme Lead.

Her deep passion for palliative care and the ‘person in the patient’ was ignited during her student nurse training in the 1980’s.

Having held many clinical and healthcare leadership roles, including executive director of a palliative care community interest company, Laura is now relishing the challenge of working with others to consider the needs of the West Midlands population as a whole.

An advocate of the power of ‘human’ leadership and mobilising others for change, Laura is a student of the School for Health and Care Radicals and the Nye Bevan Programme – Leading Care III, NHS Leadership Academy.

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  1. Tony Davis says:

    I am chairperson of a PPG Group in Corringham Essex – I was asked by one of my members about the over 75’s as a matter of course if in the event of a life threatening condition where their life is in danger, do they want to be resuscited in the event of them becoming unable to make the decision themselves.

    Is this something the NHSE has given advice on to GP practices in England ?

    Thank you

    • Laura Tooley says:

      Just spotted this reply Tony, I’m so sorry. Would you like to drop me an e-mail so we can respond directly to you?

      Many thanks,


  2. Preth Rao says:

    Laura – It’s great to see your passion for end of life care. As someone working in an end of life care charity we are hugely hopeful about the improved joined up models of care that vanguard sites may deliver for people at the end of life who can often fall out of a system and not have access to timely care in the community.

    • Laura Tooley says:

      Just spotted this reply Preth, I’m so sorry.

      Thank you for your insightful comment and we are having conversations with Vanguards about the importance of palliative and end of life care.

      Many thanks,