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["Baseline assessment: End of life care for adults: service delivery"]
["NG142"]
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["Published: October 2019"]

{"sheet":"Introduction","index":1,"n_rows":23,"n_cols":1,"rows_kept":23,"cut":false,"hidden":false,"merged":[]}
["Baseline assessment tool for end of life care for adults: service delivery (NICE clinical guideline NG142)"]
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["This baseline assessment tool can be used to evaluate whether practice is in line with the recommendations in End of life care for adults: service delivery.  It can also help to plan activity to meet the recommendations."]
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["The tool can be used by individual services or organisations. Alternatively, an assessment completed with the involvement of all relevant services or organisations would help to develop a picture of activity in the local area."]
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["It should be used in conjunction with End of life care for adults: service delivery (NICE clinical guideline NG142)."]
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["In the first instance, consider whether the guideline is relevant and record the conclusion in the box below."]
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["Is the guideline relevant?"]
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["The data sheet contains the recommendations from the guideline. Information can be entered about current activity relevant to the recommendation, actions needed to meet the recommendation, deadlines and the names of the responsible leads.  Useful documents can be added as hyperlinks."]
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["The table can be adapted to include any other local information that is thought to be useful."]
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["If it would be helpful to group the recommendations, for example those that are key priorities for implementation or by deadline, use the filter function in the data menu. "]
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["Tools and resources to help put the guidance into practice are available on the NICE website. "]
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["National Institute for Health and Care Excellence\nLevel 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT; www.nice.org.uk\n\nCopyright\n© NICE 2019. All rights reserved. Subject to Notice of rights.\n"]

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["Baseline assessment tool for end of life care for adults: service delivery (NICE clinical guideline NG142)"]
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[null,null,null,"Number of recommendations met",{"$f":"COUNTIF(E8:E53,\"Yes\")","v":0}]
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[]
["NICE recommendation","Guideline reference","Is the recommendation relevant?","Current activity/evidence","Recommendation met?","Actions needed to implement recommendation","Is there a risk associated with not implementing this recommendation?","Is there a cost or saving?","Deadline","Lead"]
["1.1  Identifying adults who may be approaching the end of their life, their carers and other people important to them"]
["People managing and delivering services should develop systems to identify adults who are likely to be approaching the end of their life (for example, using tools such as the Gold Standards Framework, the Amber Care Bundle or the Supportive and Palliative Care Indicators Tool [SPICT]). This will enable health and social care practitioners to start discussions about advance care planning and to support people's preferences for where they would like to be cared for and die.","1.1.1"]
["Health and social care practitioners should identify carers and other people important to adults who are likely to be approaching the end of their life.","1.1.2"]
["1.2  Assessing holistic needs"]
["If it is thought that an adult is approaching the end of their life, carry out an initial holistic needs assessment with the person and document this. This will enable the right support to be provided when it is needed.","1.2.1"]
["People managing services should ensure that health and social care practitioners caring for adults approaching the end of their life have the training and skills to sensitively carry out holistic needs assessments.","1.2.2"]
["Healthcare practitioners should be aware of the requirement to offer a carer's needs assessment in line with the Care Act 2014 and a young carer's needs assessment in line with the Children and Families Act 2014.","1.2.3"]
["1.3  Supporting carers"]
["People managing and delivering services should think about what practical and emotional support can be provided to carers of adults approaching the end of their life and review this when needed.","1.3.1"]
["When carers' needs are identified, take into account that the support needs of a young carer are likely to be different to those of an older carer.","1.3.2"]
["1.4   Providing information"]
["For advice on communication, information and shared decision making, see the NICE guidelines on patient experience in adult NHS services and people's experience in adult social care services. Apply the same principles for communication and information giving to carers of all ages.","1.4.1"]
["For people with learning disabilities, use this guideline alongside the recommendations on end of life care in the NICE guideline on care and support of people growing older with learning disabilities.","1.4.2"]
["Support and enable adults approaching the end of their life to actively participate in decision making by having in place:\n•\tprocesses to establish the amount and type of information they would prefer\n•\tsystems to provide information in a way that meets their communication needs and preferences, for example, how it is given (verbally, on paper, by text, email, or other assistive technologies) and provision of professional interpreters\n•\tarrangements to review and anticipate their information needs and preferences as circumstances change.","1.4.3"]
["1.5  Reviewing current treatment"]
["For advice on reducing treatment burden and reviewing medicines and other treatments, see the NICE guidelines on multimorbidity and medicines optimisation.","1.5.1"]
["Develop policies for reviewing treatment within all specialties to meet the changing needs of adults approaching the end of their life and to reduce the burden of unhelpful treatments. Different services should work together and share information about treatment reviews (see section 1.10 on providing end of life care coordination).","1.5.2"]
["The lead healthcare professional should ensure that the person approaching the end of their life is offered opportunities to discuss their existing treatment plans with a healthcare professional. The person's carers and other people important to them should be included in the discussions, if the person agrees. This should include discussing:\n•\tany changes that could optimise care and improve their quality of life (for example, reducing the number of unnecessary routine appointments, organising appointments close to the person's home, starting new treatments or stopping unhelpful treatments)\n•\tcommunity support available to help with their treatment.","1.5.3"]
["1.6  Advance care planning"]
["Service providers should develop policies to ensure that advance care planning is offered to adults who are approaching the end of their life. Policies should take into account under-served and vulnerable groups.","1.6.1"]
["Service providers should develop processes to support carers and other people important to the person to be involved in advance care planning, if the person approaching the end of their life agrees.","1.6.2"]
["Service providers should have systems in place to ensure that adults approaching the end of their life each have a copy of their advance care plan available in their place of residence or with them if admitted to a hospital, care home or hospice.","1.6.3"]
["Service providers should develop processes to take into account the views of carers and other people important to the person if the person approaching the end of their life lacks capacity to make decisions in line with the Mental Capacity Act 2005.","1.6.4"]
["For advice on supporting decision making, assessing mental capacity and advance care planning, see the NICE guideline on decision-making and mental capacity.","1.6.5"]
["For advice on starting advance care planning in adults who: \n•\tare at risk of a medical emergency, see the NICE guideline on emergency and acute medical care in over 16s\n•\thave motor neurone disease, see the NICE guideline on motor neurone disease\n•\thave multimorbidities, see the NICE guideline on multimorbidity\n•\thave dementia, see the NICE guideline on dementia\n•\thave learning disabilities, see the NICE guideline on care and support of people growing older with learning disabilities.","1.6.6"]
["For advice on organ donation, see the NICE guideline on organ donation for transplantation","1.6.7"]
["1.7   Reviewing needs "]
["Develop systems enabling adults approaching the end of their life to have:\n•\tregular discussions with a member of their care team about changes in their health and social care needs and preferences\n•\trepeat assessments of their holistic needs and reviews of their advance care plan when needed, for example at key transition points, such as at discharge from hospital or when the goals of treatment have changed.","1.7.1"]
["1.8   Communicating and sharing information between services"]
["Adults approaching the end of their life should have care that is coordinated between health and social care practitioners within and across different services and organisations, to ensure good communication and a shared understanding of the person's needs and care.","1.8.1"]
["Use electronic information-sharing systems that are accessible between different services and organisations to enable information to be reviewed, updated and shared efficiently within and between multipractitioner teams, across different services and organisations.","1.8.2"]
["For specific advice on coordinating end of life support in residential settings, see the NICE guideline on people's experience in adult social care services.","1.8.3"]
["1.9   Providing multipractitioner care "]
["Provide access to the expertise of highly skilled health and social care practitioners, when needed, for adults approaching the end of their life, their carers and other people important to them. They should have the skills to:\n•\tmeet complex care and support needs\n•\tanticipate and prevent or minimise crises\n•\tsupport people's preferences for where they would like to be cared for and die, if possible.","1.9.1"]
["Health and social care practitioners should have the skills to provide care for adults approaching the end of their life who need support in the following areas:\n•\tdisease-specific, including symptom management, hydration and nutrition, and access to medication\n•\tphysical \n•\tpsychological\n•\tsocial, including support and advice (for example, signposting advice on benefits, finance and third-sector, local or national support services)\n•\tsupport with activities of daily living, including access to equipment and rehabilitation services\n•\tpastoral, religious and spiritual\n•\tcultural.","1.9.2"]
["1.10   Providing end of life care coordination"]
["Provide end of life care coordination for adults who are approaching the end of their life through:\n•\tcommunity and primary care services for adults, provided by the person’s GP or another health and social care practitioner in the primary or community care team\n•\thospital services for adults whose treatment is based in secondary or tertiary care, provided by health and social care practitioners based in hospices or disease-specific specialists in hospitals. ","1.10.1"]
["For people in under-served and vulnerable groups who are approaching the end of their life, provide additional support that takes into account the challenges of coordinating care for people in these groups. ","1.10.2"]
["Ensure that there is good communication between health and social care practitioners coordinating community-based care and health and social care practitioners coordinating hospital care.","1.10.3"]
["Health and social care practitioners providing end of life care coordination should:\n•\toffer information to the person approaching the end of their life, their carers and others important to them, about who the multipractitioner team members are (including the lead healthcare professionals in each setting responsible for their care), the roles of the team members and how services are accessed \n•\tensure that holistic needs assessments are offered and the person's wishes and needs are discussed and acted on whenever possible\n•\tensure that care is coordinated across and between the multipractitioner teams and between care settings\n•\tensure that regular discussions and reviews of care, holistic needs and advance care plans are offered \n•\tshare information about the person’s care between members of the multipractitioner teams.","1.10.4"]
["1.11   Transferring people between care settings"]
["For advice on transitions between care settings for adults with social care needs, see the NICE guideline on transition between inpatient hospital settings and community or care home settings for adults with social care needs.","1.11.1"]
["Develop systems to support smooth and rapid transfer between care settings for adults approaching the end of their life. For example, organise services so that: \n•\tambulances or other transport services can move people between care settings without delay and in an efficient and compassionate way\n•\tcare packages and equipment are available to enable adults approaching the end of their life to move to the place where they would like to be cared for and die.","1.11.2"]
["Develop an agreed transfer policy between ambulance service providers and acute care providers to enable the rapid transfer of adults approaching the end of their life to the place where they would like to be cared for and die whenever rapid transfer is a priority.","1.11.3"]
["1.12   Providing out-of-hours care "]
["Adults approaching the end of their life, their carers and other people important to them should have access to:\n•\ta healthcare professional available 24 hours a day, 7 days a week, who can access the person's records and advance care plan, and make informed decisions about changes to care\n•\tan out-of-hours end of life care advice line\n•\tan out-of-hours pharmacy service that has access to medicines for symptom management in adults approaching the end of their life.","1.12.1"]