Using care profiles as a catalyst for improving end of Life commissioning, involvement and service delivery.

Objectives In 2010, Liverpool Primary Care Trust successfully pioneered a care profiles approach to commissioning End of Life (EoL) services. They established service requirements for each stage of the EoL pathway, and set out skill mix, delivery, quality and outcomes. This feature sets out how the approach can also support local work relating to Advance Care Planning, palliative care funding tariffs and patient and public involvement. Situation Local EoL services vary, reflecting geography, history, service models and resources. Few commissioners know in detail how all EoL services and resources systematically inter-relate, particularly those involving non-specialist services. Also, anecdotal evidence indicates that information provided by healthcare professionals to patients and carers is not necessarily consistent or complete. Finances The planned introduction of per patient tariffs for palliative care in 2015 means commissioners must be clear about what EoL services are and what are not covered by the tariffs, and how this might impact on service delivery and contracts. Information A multi-disciplinary workshop established that by clarifying what services are commissioned locally, EoL care profiles can provide detailed information to ensure patients and carers receive comprehensive, consistent, quality information to support their Advanced Care Planning. They can address gaps in EoL information prescriptions and enable transparent information for patient and public involvement. Conclusions EoL care profiles enable local services to be commissioned in detail, which is a catalyst and essential precursor for an inclusive and explicit approach to planning and resourcing services for individual patients and the population as a whole.