Abstract
High-quality community nursing is essential to ensure that end-of-life care can be provided in community settings in line with patient preferences. This article examines the quality priorities commissioners sought to incentivise in end-of-life care, by reviewing a survey of Commissioning for Quality and Innovation (CQUIN) indicators for community nursing conducted in England in 2014-2015. Findings from the survey suggest that end-of-life care was not given a high priority with the CQUIN indicators for community nursing. Vigorous quality standards, including training and development, need to be in place to make sure that the potential of community nursing is being used to sensitively engage with people nearing the end of their lives and support them to plan their future care, if they so wish.
Highlights
Identification of more people at the end of their lives and those with non-cancer diagnoses, like chronic disease, dementia and frailty, is an important NHS initiative (NICE, 2011)
This article seeks to examine what quality priorities commissioners sought to incentivise in end of life care, by reviewing a survey of Commissioning for Quality and Innovation indicators for community nursing conducted in England, 2014-15
Emerging findings from the survey suggest that end of life care did not have a high priority with the Commissioning for Quality and Innovation (CQUIN) indicators for community nursing
Summary
Identification of more people at the end of their lives and those with non-cancer diagnoses, like chronic disease, dementia and frailty, is an important NHS initiative (NICE, 2011). It is clear that indicators of high quality service around identification of those nearing the end of their lives and their future care planning should reflect the context and the sensitivity of how these issues are introduced and discussed with people, and not just be about targeting greater numbers. This article examines emerging findings from a survey of Commissioning for Quality and Innovation (CQUIN) indicators for community nursing in England in 2014-15 (Horrocks et al, 2015 unpublished report), focusing on indicators for EoLC. Two researchers undertook further analysis of the thirty-six local end of life CQUIN indicators, focusing on the intended goal and the milestones required to achieve the indicator These were categorised into sub-themes to identify what aspects of EoLC were important to incentivise at a local level. It is possible that this was being collected through different mechanisms alongside the CQUIN indicators
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