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

This is a national framework aimed at local health and social care and community leaders. It builds on the Department of Health’s 2008 strategy for end of life care and responds to an increased emphasis on local decision making in the delivery of palliative and end of life care services since the introduction of the Health and Social Care Act 2012. This 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:

1. Each person is seen as an individual.
2. Each person gets fair access to care.
3. Maximising comfort and wellbeing.
4. Care is coordinated.
5. All staff are prepared to care.
6. 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

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, St Julias/Mount Edgcumbe (Cornwall) and St Lukes (Plymouth) Hospices, Macmillan, Marie Curie, Plymouth Hospitals NHS Trust, primary care (GPs, practice nurses and pharmacists), Royal Cornwall Hospitals NHS Trust and South West 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 tThe 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. Find out more about Healthwatch’s end of life conference.

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. Telephone 01872 221102.

Cornwall hospice care

A palliative care advice line is available to healthcare professionals 24 hours a day, 7 days a week. This provides access to specialist nursing and medical advice at any time on symptom control, syringe driver and drug use, appropriate place of care and management of palliative care emergencies. Telephone 01736 757707.

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 cornwall.spcadvice@nhs.net.

Marie Curie

Call the Marie Curie support line on 0800 090 2309, Monday to Friday 8am to 6pm and Saturday 11am to 5pm). You can also get terminal illness support on their website.