Rationale/background Advance care planning (ACP) is recognised as being key to improving end of life care. A high proportion of people feel comfortable talking about death and dying but historically conversations have been left until a palliative diagnosis or not done at all. Families are often left to guess and make difficult decisions about care and treatment when a loved one loses capacity.
Objective Aims of the project include the development of tools, a training programme and resources to help transform professional and public attitudes to ACP and reduce the barriers, including a lack of resources, limited public awareness and professional hesitancy.
Method An assessment of local recording systems led to the development of a new template to simplify the creation of ACPs on the electronic patient record system. A public ACP booklet has been produced for anyone to record their wishes and preferences and to raise the profile of ACP. Training has commenced at the hospice, in care homes and at other locations, to improve competence.
Results The electronic template is operational and has also been adopted by GPs and district nurses. The hospice is leading by example, aiming to offer 100% of appropriate patients an ACP conversation. The new ACP booklet is available to download online or pick up from various outlets. 200 people have attended ACP training at the hospice: evaluations demonstrate an improvement in knowledge and confidence.
Conclusion It is likely that the role of hospice staff will change from creating ACPs to reviewing existing documents when patients are referred. There is no ‘right time’ to start an ACP, but whether in good health or not, nobody is immune from sudden illness or accidents; an ACP can help ensure everyone receives care and treatment in line with their wishes and preferences.
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