Since 2008 the North West Clinical Pathway Group has been working to improve End of Life Care for the people of the North West. 

The Cumbria and Lancashire End of Life Care Network has applied the following eleven key recommendations made by the End of Life Clinical Pathway Group in guiding agenda and the focus of workstreams.

1. A robust integrated commissioning framework based on the North West end of life care model should be developed across health, social care, voluntary, charitable and independent sectors, with identified strategic leadership within each Primary Care Trust (PCT).  This framework should enable a 10% reduction in hospital deaths by 2012.
2. Quality standards with associated measures should be developed to support self-assessment based on the North West EOLC strategy by August 2008.
3. A public campaign should be established to raise awareness about end of life care resulting in a more open conversation within society which also engages people’s views about death and dying.
4. The NHS North West should continue to build on the current success of implementation of the National End of Life Care tools. Gold Standards Framework, Liverpool Care Pathway and Preferred Priorities for Care (GSF; LCP; PPC).
5. Advance care planning (ACP) should be undertaken in all sectors of care preferably electronically based.  A person’s preferences and choices should be identified, fully shared with all relevant staff and accessible 24 hours a day, 7 days a week.
6. Fully integrated and co-ordinated services should be available across organisations with 24 hour and 7 day access to specialist palliative care services.  This should be underpinned by a single point of access for the person and their carers including documented evidence of the use of supportive care registers.
7. There should be in place evidence of comprehensive holistic assessment that clearly meets the person’s individual needs.  The assessment should be based on the North West EOLC model and standards.
8. Support should be provided for carers of all ages during the person’s life and during the bereavement phase.
9. Workforce development with mandatory training and education in end of life care with a particular emphasis on effective and sensitive communication should be provided for all relevant staff, (clinical/non clinical) on a continuing basis.  This is fundamental to ensuring quality in end of life care and must be a key feature in local delivery plans.
10. A strategy should be developed by the Strategic Health Authority (SHA),  PCTs and the local authority  to support a culture of change in end of life care, incorporating research, innovation and service improvement.
11. A financial investment programme should be identified to support the delivery of the health and social care, commissioning strategy.