Health and Care Bill — House of Lords, 2022-03-01
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, I must declare that I am a vice-president of Marie Curie and of Hospice UK. I am most grateful for the kind and generous words that have already been said about me and the work on this amendment. I must thank both Ministers, the team and the officials for all the work they have done on this subject. I also thank the charities Marie Curie, Sue Ryder, Hospice UK, Alzheimer’s Society and Together for Short Lives, and particularly those people who have generously shared their experiences of supporting someone they love who is living with a terminal illness Palliative care is not an add-on or aftercare, but must be integrated as an essential part of NHS provision. As we move forward, I want to pick up the point that the provision of services for people who need palliative care must include specialist palliative care as core. Specialist care is provided by multiprofessional teams. These doctors and nurses have specialist training, usually working with allied health professionals who also have become specialised in their way. Hospice care assistants in health and social care have also been specially trained, and others, including multidenominational services and counselling and bereavement support for children and adults, are all part of the wider provision People need support in every setting, whether at home or in a care home, hospital, hospice or some other community setting, which includes places such as prisons. In all these settings, the specialist palliative care team works with local clinicians to provide expert advice at all times of the day, every day, supporting health and social care professionals who are providing care to the person and their family. Sadly, as has been said, palliative care is currently patchy, and it must be available wherever people are, as the noble Lord, Lord Howarth, said in his remarks. It must be available for all ages, to reflect on the comments of the noble Baroness, Lady Brinton My Amendment 17 sets out the criteria for specialist multiprofessional palliative care services, based on the World Health Organization commissioning guidance. I hope it will act as a guide to all integrated care boards in determining what they will now commission and from whom. In many areas, their local hospice services will be able to have a better contract, spelling out what is expected of them and what is available to them by better integration. In some other areas, services will need to be grown and developed over time The charitable hospice world is committed to working with the NHS in an integrated way, leaving the charity free to fundraise for whatever additional, non-core services should be provided to improve the quality of life of patients and their families in their area. Where there are specialist beds, usually in a local hospice, they need to be able to take patients on an urgent basis, as disease does not respect the clock or the calendar Specialist palliative care has an important role in supporting the education and training of the health and social care workforce in the area at all levels, as has been said, as well as supporting and participating in relevant research and disseminating evidence-based innovations for rapid rollout. As services develop and move forward, being linked to a What Works centre initiative will help ensure that there is rapid dissemination of new knowledge and skills. Integrated palliative care services can provide support to ensure the right skilled workforce, equipment and medication are available, with a point of contact for people with palliative care needs if their usual source of support is not accessible This is all in place in some areas already, with appropriate systems to share information with the person’s consent, to ensure that all professionals involved know about that person’s needs and what matters to them and their family. As services develop, that will be of great benefit in ensuring that the core team members, if provided through a hospice, have honorary contracts so that they can go into NHS hospitals and provide support as needed, as we saw during the peak of the pandemic. At that time, it was said that palliative care had come into its own, providing support in intensive care units, high dependency units and emergency departments, as well as in the community and on wards May I share with the House the fact that I have had correspondence of jubilation from colleagues in palliative care, because this recognition means that they feel they finally have equal status with other NHS services and can integrate better, whether with oncology, neurology, cardiology, surgery, anaesthetics and many other services? Such integration can ensure that patients get what they need when they need it, whether it is radiotherapy to relieve bone pain or halt a spinal cord compression or an urgent nerve block or a surgical opinion.