NHS Constitution reform: new end-of-life care pledge

New commitments on end-of-life care and single-sex wards are set to be included in the NHS constitution under proposals unveiled on Monday.

Ministers said the wide-ranging package of reforms would empower patients and ensure their wishes come first. (Story first featured in The Guardian…)

Measures may include suing health trusts that fail to fully discuss issues and striking off doctors who ignore patients’ wishes. Rules on involving patients and families in treatment decisions are being strengthened following an outcry over secretive use of the Liverpool Care Pathway which involves withdrawal of fluids and food. Under the measures being put out for consultation, health trusts that fail to discuss issues properly could be sued. Doctors who ignore the wishes of patients and relatives face being struck off. For the first time, the coalition’s policy on single sex wards would be included in the constitution. It would pledge that those admitted to hospital “will not have to share sleeping accommodation with patients of the opposite sex”.

Other planned changes include:

• A new right for patients to receive acknowledgement, an explanation and apology where mistakes have been made;

• A commitment that complaints will be acknowledged within three working days, and tougher rules on handling them;

• A warning that abusive and violent patients could be denied access to NHS services, if it is “safe” to do so;

Health minister Norman Lamb said the government was determined to protect the founding principles of the health service. “The NHS is one of this country’s greatest achievements. This government will always make sure it is free to all, no matter your age or the size of your bank balance,” he said. “That’s why at the same time as we are protecting its budget, we are strengthening this constitution, which enshrines the right of everyone to have first class care, now and in the future.”

Marie Curie Cancer Care welcomed the proposed new legal right for patients to be consulted on end-of-life care decisions. But the charity said the government should go further and called for the next independent national audit of the Liverpool Care Pathway to be brought forward.

Imelda Redmond, director of policy and public affairs at Marie Curie, said: “The Liverpool Care Pathway has enabled thousands of people to experience dignified care in the last hours and days of life. It was developed to spread the hospice model of end of life care into hospitals and other healthcare settings. We have become increasingly concerned about the damaging media coverage which reports negative experiences of people in hospital and the end of life. That is why we are calling for the next independent national audit to be brought forward so that we can identify as soon as possible where these failings are taking place. Once this is done, an action plan must be put in place for improvements where care is below the highest standards that the public expects.”