Public awareness of palliative care is to be enhanced so that it becomes normal to consider the end of life. Awareness of palliative care among care providers is also to be enhanced, and it should become common practice to consider whether treatment should be continued.
More people should be able to die at the place of their choosing (generally at home) than in 2014. Care is to be arranged as close to home as possible, and primary and secondary care are to be joined up more effectively. Palliative care is to become part of regular healthcare provision, and better coordinated with care services for the elderly and the welfare sector, for example. Specialist and multidisciplinary knowledge should be made available more quickly, with more consideration of the social and spiritual dimensions during the palliative phase.
Standards of palliative care will have improved. Everyone working in care is to have a good basic knowledge of palliative care (including the social and spiritual dimensions). Fewer people will suffer unnecessary pain and respiratory distress as they die. Knowledge of and organisation of palliative care for special groups (children, mental health service patients, people with learning disabilities, people with dementia, homeless people) must improve.
The needs and wishes of people in the final phase of life and their families are to be the key focus. People in the final phase of life, including special groups, are to be more involved as partners in palliative treatment. Informal carers must suffer less overload. Deployment of trained volunteers in the final phase of life should be possible in all places where people spend their final days and weeks.
All projects must have research, practice and training components. The training component requires an extra focus for, despite the fact that palliative care should be seen as generalist care, there is a knowledge and skills gap among professionals. In some cases it is a matter of inability to provide adequate care, or of unconscious incompetence.
We already know a great deal and many examples of best practice are already being applied. This programme wants to bring together this knowledge and best practice and spread it throughout the country, allowing us to make improvements more quickly, and prevent the wheel from continuously being reinvented. Conversely, the programme will also be critical as regards interventions or methods that are found not to work, or whose effect is unclear. Just as implementation can constitute an improvement, so can discontinuing an ineffective practice.
The prospect of achieving a noticeable improvement in care for patients and their families is the basic principle, and it is on this basis that the best plan of action will be proposed for each project, depending on the issue. This might result in a practice-oriented study with an equal proportion of practice and research activities, but it might also be that a fundamental research question first has to be addressed before any progress can be made towards improvements in practice.