Living and Dying Well in Scotland

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Living and Dying Well` aims to enable NHS Boards to plan and develop services. These services are about end of life care for patients and families.` Notice that LIVING AND DYING WELL is more about dying than living. The Government is encouraging NHS Boards to be on the hunt for vulnerable patients. It`s the same agenda as in Dying Matters who encourage GPs to look for their one percent.  Here is what they have to say:

We need to identify those who would benefit from it. [Benefit is not defined here]. Certain triggers will lead to an assessment or review of end of life care needs. [Needs appear to be physical, social, emotional and spiritual? But are some of these the business of the NHS?] The triggers for a review of end of care needs are:

diagnosis of a progressive or life-limiting illness [How limiting does it have to be? Not defined.]

critical events or significant deterioration during the disease trajectory indicating the need for a 'change of gear' in clinical management. [Change of gear? Stop thinking cure and start thinking palliative care.]

significant changes in patient or carer ability to 'cope' indicating the need for additional support. [What additional support?]

the 'surprise question' (clinicians would not be surprised if the patient were to die within the next 12 months)

onset of the end of life phase - 'diagnosing dying'.

[The problem is that diagnosing dying is not an exact science. So a change of gear may be inappropriate.]

 

 

Is the system being set up not more about cutting costs than providing care?

See The Liverpool Care Pathway - cost efficiencies