Providing high-quality care at the end of life: the role of education and guidance

Palliative care in the UK has been ranked as the best in the world. So where did palliative care go so wrong that a 168-page document is required to inform staff how to care for dying patients if it has been going so well for so long? Those nearing the end of their life deserve to be given optimum care, attention, compassion and consideration, but this is not always the case. The Liverpool Care Pathway was a tool originally devised to help health professionals provide high-quality end-of-life care to people in the final phase of life. This tool, when used in the correct way, could provide the 'gold standard' of end-of-life care for patients. However, a national review found that rather than a tick-box exercise, care of the dying should be centred around individualised care planning for the dying patient, as highlighted in the publication of the guidance: One Chance to Get It Right. Care of the dying is a complex skill that requires nurses to provide some of the most challenging care, and for which many nurses have received little or no training. The implementation of this guidance into practice will require thoughtful change management, abandoning an old way of working in order to ensure excellence and high-quality care for patients nearing the end of life.