BMJ Support Palliat Care 3:11-17 doi:10.1136/bmjspcare-2012-000214
  • Features

Using care profiles as a catalyst for improving end of life commissioning, involvement and service delivery

  1. Brenda Roe1,3
  1. 1Health & Social Care, Edge Hill University, Ormskirk, UK
  2. 2Liverpool Business School, Liverpool John Moores University, Liverpool, UK
  3. 3Personal Social Services Research Unit, University of Manchester, Manchester, UK
  1. Correspondence to Robert Gandy, Health & Social Care, Edge Hill University, c/o 13 Woodkind Hey, Spital, Wirral, CH63 9JY, UK; rob.gandy{at}
  1. Contributors RG and BR conceived and designed the workshop and feature article. It builds upon their published work on End of Life Care Profiles (with co-author Jean Rogers)7 and sets out how this commissioning methodology relates to, and can be used to support key areas of End of Life Care, primarily Advance Care Planning, palliative care funding tariffs and patient and public involvement. With regard to Advance Care Planning, RG and BR undertook empirical data collection and analysis. RG drafted the manuscript, and both authors revised it critically for important intellectual content, prior to giving final approval of the version to be published.


Objectives In 2010, Liverpool Primary Care Trust successfully pioneered a care profiles approach to commissioning End of Life (EoL) services. They established service requirements for each stage of the EoL pathway, and set out skill mix, delivery, quality and outcomes. This feature sets out how the approach can also support local work relating to Advance Care Planning, palliative care funding tariffs and patient and public involvement.

Situation Local EoL services vary, reflecting geography, history, service models and resources. Few commissioners know in detail how all EoL services and resources systematically inter-relate, particularly those involving non-specialist services. Also, anecdotal evidence indicates that information provided by healthcare professionals to patients and carers is not necessarily consistent or complete.

Finances The planned introduction of per patient tariffs for palliative care in 2015 means commissioners must be clear about what EoL services are and what are not covered by the tariffs, and how this might impact on service delivery and contracts.

Information A multi-disciplinary workshop established that by clarifying what services are commissioned locally, EoL care profiles can provide detailed information to ensure patients and carers receive comprehensive, consistent, quality information to support their Advanced Care Planning. They can address gaps in EoL information prescriptions and enable transparent information for patient and public involvement.

Conclusions EoL care profiles enable local services to be commissioned in detail, which is a catalyst and essential precursor for an inclusive and explicit approach to planning and resourcing services for individual patients and the population as a whole.


  • Funding The work relating to this feature was unfunded, including the workshop where the relationship between End of Life Care Profiles and Advance Care Planning was explored. The use of facilities and the refreshments for the workshop were kindly provided at no charge by Woodlands Hospice.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The nature of the feature article mostly involves a review of literature including the paper about End of Life Care Profiles recently published in Primary Health Care Research & Development, and the paper about PPI and End of Life services recently published in the British Journal of Health Care Management and then establishes how a Care Profiles approach can support key End of Life services objectives. The only empirical data are the outputs from the workshop that focused on using information from the End of Life Care Profiles to support Advance Care Plans. The accuracy of these notes was endorsed by all who attended. A copy of the notes, suitably anonymised, can be made available, if required, from the corresponding author.

  • Received 8 February 2012.
  • Accepted 9 June 2012.
  • Published Online First 2 August 2012

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