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<p>On 5 July 2016 we published Our Commitment to you for end of life care, which set
out what everyone should expect from their care at the end of life and the actions
we are taking to make high quality, personalised care a reality for everyone, including
infants, children and young people. We remain committed to improving services and
ending variation in end of life care by 2020. A copy of Our Commitment to you for
end of life care can be found at the following link:</p><p> </p><p><a href="http://www.gov.uk/government/publications/choice-in-end-of-life-care-government-response"
target="_blank">www.gov.uk/government/publications/choice-in-end-of-life-care-government-response</a></p><p>
</p><p>Through the Mandate, we have asked NHS England to deliver the Choice Commitment,
and through NHS England’s National Programme Board for End of life Care, a range of
activity is being undertaken with all key system partners, including Public Health
England (PHE) and Health Education England (HEE) to achieve this. The HEE Mandate
sets out an objective to deliver the parts of the Choice Commitment relevant to training
and education in end of life care. The remit letter from the Government to PHE sets
out the high level objectives for PHE, but it is not exhaustive and does not include
every disease or area of care relevant to PHE activity. However, the letter sets out
a range of requirements around, information, data, tools and guidance to support the
system to meet legal duties to improve the public’s health and reduce health inequalities.
In response, PHE’s end of life care intelligence network provides an extensive range
of data on services and outcomes to improve end of life care and reduce inequalities.</p><p>
</p><p>To support health and care professionals employed by the National Health Service
and other agencies to meet the Government’s end of life care choice commitment to
infants children and young people by 2020 a range of activity has been undertaken.
In 2017 HEE, in partnership with Skills for Care and Skills for Health, published
refreshed End of Life Care Core Skills Education and Training Framework. This aims
to standardise end of life care training and education, and as the guidance sets out,
much of it is applicable to infants and young children. A copy of the framework is
available at the following link:</p><p> </p><p><a href="http://www.skillsforhealth.org.uk/services/item/536-end-of-life-care-cstf-download"
target="_blank">www.skillsforhealth.org.uk/services/item/536-end-of-life-care-cstf-download</a></p><p>
</p><p>NHS England has published an End of Life Care Commissioning Toolkit which provides
a wide range of links to tools and sources of support for both commissioners and providers
of services. It sets out best practice and seeks to demonstrate what a well-commissioned
end of life care service looks like, and the guidance is relevant to infants, children
and young people.</p><p> </p><p>NHS England is also working with key stakeholders,
including end of life care charities, to support the implementation of The Ambitions
for Palliative and End of Life Care: A national framework for local action 2015-2020.
The framework exemplifies the Government’s commitment to ensuring everyone, including
infants, children and young people, can receive high quality, compassionate and personalised
care and sets out the actions that will be taken in local areas to improve care. Through
the Ambitions Partnership knowledge Hub, a range of guidance on training and service
planning, including case studies, has been made available.</p><p> </p><p>The Department
also asked the National Institute for Health and Care Excellence (NICE) to develop
guidance on end of life care for children. As a result, in December 2016, NICE published
End of Life Care for Infants, Children and Young People: Planning and Management,
to support local services in the delivery of high quality end of life care particular
to the needs of this group of patients, and their families. The guidance covers the
planning and management of end of life and palliative care for infants, children and
young people with life-limiting conditions. The guidance (which covers those aged
0–17 years) was developed with the help of children at the end of their lives, as
well as their brothers and sisters, in order to reflect what they felt was important
from their care.</p><p> </p><p>The Government’s end of life care commitment progress
report, published on 21 September 2017, highlighted specific work on the NICE guidance
NHS England has commissioned from Together for Short Lives, who are the leading children’s
end of life care charity. Together for Short Lives are examining services across the
country to identify best practice in implementation of the guidance, as well as the
current barriers, through interviews with local NHS services. Copies of One year on:
the government response to the review of choice in end of life care, and the NICE
guidance, can be found at the following links:</p><p> </p><p><a href="http://www.gov.uk/government/publications/choice-in-end-of-life-care-government-progress"
target="_blank">www.gov.uk/government/publications/choice-in-end-of-life-care-government-progress</a></p><p>
</p><p><a href="http://www.nice.org.uk/guidance/ng61" target="_blank">www.nice.org.uk/guidance/ng61</a></p><p>
</p><p>Finally, as the national body for education and training, HEE provides national
leadership and co-ordinates workforce planning, education and commissioning activity
to ensure that sufficient numbers of skilled workers are available for the NHS in
England. At a local level, each NHS provider produces an assessment of their future
needs that form the basis of local area plans, which are then used by HEE to create
meaningful forecast at a national level and the basis for discussion with stakeholders
as to whether this supply will match the system's view of future demand. This analysis
and discussion is then used to identify whether any changes are required to the volumes
of training commissioned by HEE.</p><p> </p><p>The NHS employs more staff now, in
2018, than at any other time in its 69 year history with significant growth in newly
qualified staff. Although data does not specifically identify nursing specialities,
such as palliative care, in palliative medicine, there are 626 (full time equivalent)
doctors working in palliative medicine, which is 179 more (40.1%) since May 2010.</p><p>
</p><p>HEE has made no assessment of the availability of health care professionals
for children’s hospices or the effectiveness of this availability. The vast majority
of hospices are independently run and recruitment and retention of staff would be
a matter for individual hospices or hospice organisations.</p>
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