New NICE Guidance on End of Life Care

NICE (the National Institute for Health and Care Excellence) has announced it has drawn up new guidance for end of life care.

It’s the first time that guidance has been given to the NHS by NICE to help improve the quality of care for terminally ill patients. It follows withdrawal of use of the Liverpool Care Pathway which was previously used by health professionals to provide end of life care in the NHS and drew widespread criticism for the way in which it was implemented.

The NICE guidance

The new guidelines suggest ways in which care can be improved in the following areas:

• recognising when a patient is entering the last stages of life;
• ensuring good communication and shared decision-making;
• support for people who want to take fluids during the last few days of life;
• taking an ‘individualised’ approach to care.

The new guidance on end of life care is emphasising the importance of establishing a proper care plan based on the needs and wishes of the individual.

For such guidance to be successfully implemented it will be important for the individual patient to have discussed their thoughts and feelings about end of life care with their family and friends as well as the health professionals involved.

This is perhaps easier said than done. Often people don’t express their thoughts about dying and in many cases even if they wanted to, they would find it impossible at the necessary time due to the effects of their illness, medication and/or mental incapacity.

Lasting Power of Attorney for Health and Welfare

This is why planning ahead and making Lasting Powers of Attorney for Health and Welfare is so important.

If you want to ensure that your family or close friends will have the final say over your end of life care, then making a Lasting Power of Attorney for Health and Welfare is the best option because it enables you to give authority to your chosen attorneys to communicate your wishes and make decisions about care and medical treatment on your behalf, if you are unable to do so yourself in the last few days or weeks of your life.

Advance Decision

If you’ve been diagnosed with a specific condition and are clear about what the effect on your body is likely to be in its later stages, then it is possible to make a document known as an Advance Decision. An Advance Decision (sometimes called a ‘Living Will’) allows you specifically to refuse certain types of treatment in advance that are associated with a particular illness or condition such as a specific type of cancer.

An Advance Decision must be very specific so unless you have already been diagnosed with a particular life-shortening condition an Advance Decision can’t be used. Instead you should consider the health and welfare LPA.

You can read more about the NICE Guidance on End of Life Care on the NICE website.

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