Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will include end of life care in the long-term plan for the NHS; and what steps are being taken to improve end of life care.

Delivering improvements to end of care is a key priority for this Government and end of life care is an important part of the proposals which are helping to shape the long-term plan for National Health Service.

NHS England is now considering the many responses and submissions it has received, including those from end of life care charities, as part of the listening exercise it held to help develop and refine policy proposals for inclusion in the plan. NHS England will continue working with key stakeholders to test the plan before its publication in November 2018.

In ‘Our Commitment to you for end of life care’, published in July 2016, the Government set out what everyone should expect from their care at the end of life and the actions being taking to make high quality and personalisation a reality for all and to reduce variation in end of life care. NHS England is responsible for delivering the commitment, in partnership with system partners and key stakeholders, through its National End of Life Care Programme Board. Key steps over the first two years include:

- Working with Public Health England and the Care Quality Commission to provide bespoke end of life care data and support packs to Sustainability and Transformation Partnerships to plan for, and improve, end of life care services;

- Testing Personal Health Budgets for people approaching the end of life;

- Working with Health Education England to ensure that all staff involved in the delivery of end of life care have appropriate education and training choice and quality of care at the end of life and strengthening medical curricula to support choice and quality and the of life;

- Inspecting and rating NHS hospital and community services for end of life care. This new inspection approach has a clear focus on end of life care and applies in all services where end of life care is delivered;

- Developing a new indicator for the Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) to measure deaths in hospital after three or more emergency admissions in the final 90 days of life to help assess choice and quality in end of life care; and

- Supporting to trusts rated as ’inadequate or ‘needs improvement’ to improve end of life care services. At the start of 2017/18, 66 trusts were in these categories (four were inadequate). This is now down to 56.

For 2018-19, the Government’s Mandate asks NHS England to increase the percentage of people identified as likely to be in their last year of life, so that their end of life care can be improved by personalising it according to their needs and preferences at an earlier stage. NHS England will use the Quality and Outcomes Framework to demonstrate such an increase by looking at the percentage of people who are on the general practitioner register for supportive and palliative care, and consider expected levels based on local populations. Currently the national English average is 0.37%, it is anticipated this figure will increase in the 2018/19 period.