Agenda item

This report sets out the recommendations arising from the End of Life Care Scrutiny Review. A copy of the full final report is attached at Appendix 1 and Councillor Funnell, the Chair of the Health Overview and Scrutiny Committee will be in attendance at the meeting to present the report.

RESOLVED:                That Cabinet agree to:

i)             Note the contents of the final report of the End of Life Care Review – ‘The Use and Effectiveness of DNACPR Forms’, at Appendix 1 of the report.

ii)           The implementation of recommendations 1 to 5, as listed at paragraph 4 of the report.

REASON:                     To fully inform the Cabinet of the outcome of this scrutiny review.

Consideration was given to a report which set out the recommendations arising from the End of Life Care Scrutiny Review, with a copy of the full final report at Appendix 1.

Cllr Funnell, as Chair of the Health Overview and Scrutiny Committee, was in attendance and presented the report detailing the consultation process undertaken with health care partners about the issues facing them. It was confirmed that all had raised concerns about care for older people and end of life care.

Review Members had gone on to identify a focus on the DNACPR Forms to ensure that patients wishes and instructions were acted upon by health care professionals and carers at the end of life. The report and recommendations had involved a considerable amount of work and engagement with all the relevant health partners.

During the course of the review it had been learnt that York Hospital had started to look at a number of work streams that fitted well with the recommendations of the review. This  included the setting up of a new York Hospital internal end of life care forum, the development of a new end of life care strategy and work plan and the employment of a lead nurse for end of life care.

Cllr Funnell went on to thank the Scrutiny Officer and colleagues for their hard work and perseverance following changes in staff and bodies responsible for this work arising from the Health and Social Care Act 2012. It was reported that the Vale of York Commissioning Group (VYCG) had confirmed their commitment to continue with the review recommendations.

The Director of Public Health, confirmed that the recommendations had been welcomed, with all health organisations working closely together. With support from the VYCG the recommendations would be shared with other Commissioning Groups.

Members referred to the need for communication with next of kin to ensure that peoples wishes were known at an earlier stage, which also involved additional training for families and health care staff.

Consideration was then given to the following recommendations:

Recommendation 1 – that key health partners, namely York Teaching Hospital NHS Foundation Trust, Yorkshire Ambulance Service, Independent Care Group and York GPs, led and co-ordinated by the Vale of York Clinical Commissioning Group look at ways of better publicising  the existence of DNACPR forms and in doing this they make use of the wealth of experience and knowledge that already exists within  voluntary organisations such as the Carer’s Forum’ and LINks (soon to be HealthWatch) to assist them with holding public events. ^1.

Recommendation 2 - That key health partners namely York Teaching Hospital NHS Foundation Trust, Yorkshire Ambulance Service, Independent Care Group, York GPs and the Out of Hours (OOH)Service led and co-ordinated by the Vale of York Clinical Commissioning Group review whether the redesigned handover forms for the OOH Service GPs have improved the sharing of information around end of life care wishes (including  DNACPR forms) and explore whether there are further improvements that can be made in relation to information sharing. ^2.

Recommendation 3 – That key health partners ensure that there are appropriate co-ordination arrangements in place to ensure that patients can discuss their end of life care wishes and those wishes are enacted. The Neighbourhood Care Teams should play a pivotal role in responding to this recommendation, in particular in terms of identifying patients most at risk of health problems and looking at ways of talking to patients about their End of Life Care needs, including DNACPR orders. ^3.

Recommendation 4 – That the Multi-Agency Workforce Development Group within the city be asked to consider how they can support all care homes within the city to achieve this. ^4.

Recommendation 5 – That once a DNACPR form is in place:

i.       there is a known protocol setting out who will undertake the review of the form and when

ii.     the review date should be clearly stated on the front of the form

iii.     there are processes in place within key health partners’ internal policies to identify which forms are due for review and how these will be undertaken

iv.    it is ensured that the completion of planned reviews is monitored. ^5.

Following further discussion, Members commended an excellent report and it was

RESOLVED:      That Cabinet agree to:

i)             Note the contents of the final report of the End of Life Care Review – ‘The Use and Effectiveness of DNACPR Forms’, at Appendix 1 of the report.

ii)            The implementation of recommendations 1 to 5, as listed at paragraph 4 of the report.

REASON:                     To fully inform the Cabinet of the outcome of this scrutiny review.