The latest in a series of good practice guides to support commissioners in designing high quality, evidence-based services to improve outcomes for patients and to help the NHS make better use of resources has been published by the National Institute for Health and Clinical Excellence (NICE).
The guide for commissioners of end of life care services aims to support local implementation of the Department of Health (2008) End of Life Care Strategy and the NICE (2011) Quality Standard for end of life care for adults, and is aligned with the NHS Outcomes Framework and supports commissioning for Quality, Innovation, Productivity and Prevention (QIPP). A recent estimate suggests that approximately 355,000 people need good palliative and end of life care services every year. However, it would appear that around 92,000 people are not being reached. Emerging evidence suggests that redesigning local end of life care pathways to enable provision of high quality end of life care can result in more people being able to die in their usual place of residence rather than in hospital, and is at worst cost neutral and has the potential to be a more efficient and effective use of resources. The guide does include an end of life care commissioning and benchmarking tool to help users determine the level of service that might be needed locally and to help cost and identify potential savings associated with commissioning end of life care services. This tool demonstrates that in England a 10% reduction in the number of hospital admissions ending in death could potentially result in a saving of £52 million.
