The 15 best practices for palliative care

In order to demonstrate consistency with regards to terminology, throughout this document the word "patient" is used in place of person with illness or client and his/her instead of their. The words "staff member" and "practitioner" are used to describe all health and community care workers or volunteers who provide palliative care.

The Palliative Care Team: The practice of palliative care is based on the concept of a team. The concept of a team acknowledges that each person, including family members can have a crucial role in providing support to the patient. The term "team" also acknowledges that providing care is a partnership between patients, their families, health and community care professionals.

The following components of an effective team are considered to be important elements of best practice palliative care:

1. Patient-centred approach: The starting point for palliative care is an understanding of the patient's perspective, needs and preferences. Providing care in this way may require palliative care professionals to work with patients to understand their concerns rather than imposing their own views on how best to provide care.

2. Team approach: The provision of palliative care is based on a team approach that recognises the important role that each team member plays. The team approach also acknowledges the importance of engaging with family members and other people who play a role in supporting the patient to provide care.

3. Communication: Clear communication between palliative care professionals, patients and their families is critical to the provision of high quality care. The development of good communication skills by all members of the palliative care team is important in achieving best practice in this setting.

4. Clinical governance: As with other health care services, it is essential that patients receive care that meets best practice criteria and accords with legislation.

5. Planning for end-of-life treatment: The provision of high quality palliative care requires that professionals develop care plans which are individualised for each patient and family. The components of the plan include the identification of patient preferences, management strategies, identification of signs of comfort or discomfort and access to appropriate medicines.

6. Care planning: Palliative care professionals identify the type of palliative care desired by patients at different stages in their illness and then work with the patient and his or her family to develop a plan for providing that care.

7. Comprehensive evaluation: The provision of palliative care requires health and community care professionals to collect information about their patients' preferences, values and needs in order to provide high quality care. Collecting this information will also contribute to better evaluation of the effectiveness of different approaches to delivering palliative care.

8. Continuity of care: Ensuring that continuity in care is provided to patients and their families throughout the illness is an important component of best practice palliative care.

9. Person-centred approach: It has been emphasised that effective communication with people who are dying should be based on an understanding of what is important to them, their cultural background and how they live out their lives.

10. Flexibility in caring for people who are dying: Healthcare professionals need to be flexible in the ways they provide care so that they can meet the needs of patients and their families throughout the course of illness.

11. Personalisation: High quality palliative care is based on an understanding and recognition of the patient as a person and not just his or her illness. The provision of high quality palliative care requires professionals to work with individuals and their families to understand what matters most in their lives, the things that give meaning to life and those aspects that are important for supporting them as they approach death. In this way, personalisation of care enables the professional to better understand the needs and preferences of individual patients and how these might best be met.

12. Self-care: One of the essential components of a palliative care team is ensuring that all team members have access to support so that they can provide high quality care to patients and their families.

13. Pastoral care: It is important that palliative care professionals recognise the importance of respecting the spiritual needs of patients and have knowledge about religions, beliefs and practices in order to respond appropriately.

14. Legal and ethical aspects: Although many of the principles underpinning best practice in palliative care are considered ethical, legal requirements may also impact on the provision of this type of care.

15. Training and education: As with other disciplines within healthcare, it is vital that palliative care professionals have appropriate training so that they can provide high quality care to patients and their families.