www.england.nhs.uk

Demonstrating

system leadership in

end of life care:

Leaders in Healthcare

Conference

Prof Bee Wee

National Clinical Director for

End of Life Care, NHS

England

1st Nov 2017

www.england.nhs.uk

Session structure

• Bee Wee:

• system leadership at national level (England): two examples

• Juliet Spiller

• implementing a standardised approach to CPR decision making across Scotland

• Joanne Bowen

• collaborative development of a strategy and implementation plan across a CCG

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End of life care National NICE

2008 National Strategy Darzi Report

2011 QS – EoLC

2013 More Care Less Pathway Health & Social Care Act

NHS England

2014 One Chance to Get it Right 5Y Forward View

2015 Health Select Committee

Choice Review

Dying Without Dignity

Ambitions Framework

NG - CODA

2016 Choice Commitments

2017 5YFV Next Steps QS - CODA

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Key issues to manage

• ‘LCP to be phased out within 6-12 months’

• Insufficient time to develop, test and implement ‘evidence-based’ replacement for LCP

• Professional distress and anxiety

• Public confidence - suspicion that LCP would be ‘rebranded’

• Radically new health care system – every organisation settling down

• Resource constraints

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Leadership Alliance for the Care of Dying People

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How professionals act and behave

How services are organised

How do we know what to do

How standards and experience are

checked

Societal attitude, behaviour and understanding

The

dying

person

People close to the

dying person

A whole-system approach:

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Collaborative leadership:

take home messages

• Invest in building the foundation

• Recognise relationship building is ongoing

• Learn to value each other

• Recognise agendas – legitimate, just different

• Recognise difference in language and culture

• Watch out for quieter voices – including dissonance

• Stay authentic but connect to wider picture as far as

possible