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Introduction
NHS Cornwall and Isles of Scilly views end of life care as a high priority and we want to ensure high quality end of life care. We want to enable choice for local people so that they can choose where they want to receive care and to ensure that they receive the best possible support.
We want to ensure that people in Cornwall achieve a good death in their preferred place of care and reduce the number of unnecessary admissions for patients at the end of their lives. This will be achieved through appropriate training, enhanced community based services and clear communication across agencies to increase positive experiences for individuals, families and carers.
People have their end of life care needs met by a wide range of professionals that may include generalist practitioners and organisations. For example care homes, care at home agencies, community nurses, hospitals and GPs. As well as specialist teams and services like a hospice, palliative care consultants or specialist nursing teams.
There is information available to help you know what to expect during end of life care and to act as a prompt for things you may want to think about. These might include how and where you want to be cared for, as well as financial issues. Talking to your family about your wishes could help them if they ever have to make decisions about your care. Knowing that they are acting in accordance with your wishes can remove some of the stress from a very difficult situation.
If you are not approaching the end of your life, you may still want to think about your wishes for your own end of life care. Think about where you would like to be cared for, where you would prefer to die, your wishes for your funeral and who you would like to make decisions about your care, if you are not able to decide for yourself.
Ambitions for palliative and end of life care
In 2015 NHS England published the Department of Health’s 2008 strategy for end of life care. The formation of our new integrated care board will offer greater opportunities to work ever more collaboratively to improve palliative and end of life care for all.
The national framework for action sets out 6 ambitions and principles for how care for those nearing death should be delivered at local level. These are:
- Each person is seen as an individual.
- Each person gets fair access to care.
- Maximising comfort and wellbeing.
- Care is coordinated.
- All staff are prepared to care.
- Each community is prepared to help.
It is crucial that our plans and pathways align with the most recent national guidance. As part of our plans, we hope to design an end of life pathway, which will include:
- better awareness about what is available locally for people at the end of their life, and what we can all do to prepare (such as make a will and talk to our loved ones about our choices and preferences)
- better identification of people in the last year of life: we want to work with health professionals so that people can receive the best possible support if they are in their last year of life, and the person and their family are supported to feel in control of the care they receive
- making sure the best possible care is in place to meet people’s needs as their condition changes and/or worsens
- a single point of access for patients, loved ones and carers across Cornwall that will coordinate care, take enquiries, signpost and help people to reach the most appropriate care and support
Working together to improve end of life care
We will bring together local organisations and work with patients and the public to develop our plans.
The groups involved are:
- care homes
- Devon Doctors
- Healthwatch Cornwall
- hospices (St Julia’s and Mount Edgcumbe in Cornwall and St Lukes in Plymouth)
- Macmillan
- Marie Curie
- Plymouth Hospitals NHS Trust
- primary care (GPs, practice nurses and pharmacists)
- Royal Cornwall Hospitals NHS Trust
- South Western Ambulance Service NHS Foundation Trust
Healthwatch Cornwall conducted research in early 2015 into the services that provide end of life care and support to Cornwall and the Isles of Scilly. From this, 5 recommendations were made, including the need for professionals to address any gaps in service or issues they faced on a day-to-day basis. Read the Healthwatch end of life care and support report.
On 29 January 2016, Healthwatch ran Cornwall’s first end of life conference: A good death. The conference was attended by health professionals across Cornwall.
End of life care support in Cornwall
Community specialist palliative care nursing team
Each GP surgery has an allocated palliative care nurse. Their aim is to ensure all patients with complex palliative care needs receive high quality symptom control assessments, psychological support and advice to meet their individual needs.
Nurses work closely with a range of health professionals in the community, hospital, hospices and other voluntary and statutory agencies.
If you think you would benefit from this service please discuss with your GP or hospital team who can refer you.
Out of hours palliative GP service
Kernow Health CIC provides an out of hours palliative GP service. Call 01872 224050.
Cornwall hospice care
A palliative care advice line is available to healthcare professionals 24 hours a day, 7 days a week. Call 01736 757707.
The helpline provides access to specialist nursing and medical advice on:
- appropriate place of care and management of palliative care emergencies
- symptom control
- syringe driver and drug use
They also operate a palliative care email hotline, which is available to healthcare professionals requiring advice quickly but without the urgency of a direct telephone conversation. Email requests for advice will be responded to within 24 hours by the consultant on call that day. Email the palliative care email hotline.
Marie Curie
Call the Marie Curie support line on 0800 090 2309. Open Monday to Friday, 8am to 6pm, and Saturday, 11am to 5pm. You can also get terminal illness support on their website.
Page last reviewed: 25 October, 2022