Looking back, looking forward: the evolution of palliative and end-of-life care in England

Abstract

Palliative and end-of-life care in England has undergone some remarkable transformations across the course of less than half a century and can be seen as a useful case study with which to understand international trends and challenges. This paper examines some of the long term influences which led to the emergence, for the very first time, of an End-of-Life Care Strategy in England. It revisits the critical contribution of Cicely Saunders to the development of a theoretical framework for palliative care before examining the gradual and as yet incomplete transformation of 'palliative care' into 'end-of-life care' which is occurring internationally. The paper then turns to examine two key challenges in contemporary end-of-life care, looking at how these are being addressed in England and forecasting the possible direction of travel in the future.

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

“…DM's ideas and personnel originate in hospice and palliative care, rather than medical specialties such as geriatrics and circulatory medicine which in the Anglophone world typically lie outside the death awareness movement. Starting with the work of Cicely Saunders in the 1950s and 1960s, hospice and palliative care have greatly improved care for people dying of cancer (Seymour, 2012).…”

Care and communication between health professionals and patients affected by severe or chronic illness in community care settings: a qualitative study of care at the end of life

“…36 It thus reflects the core components of a particular professional ideology and commitment to the nature and achievement for all patients of a particular construct of 'the good death'. [37][38][39][40] This involves the excellent control of symptoms within a holistic approach to care, which acknowledges death as a natural, rather than a pathological, process.…”

Planning for an (un)certain future: Choice within English end-of-life care

“…End-of-life care is a relatively new domain of healthcare practice, growing from the hospice movement and specialist palliative care (Seymour, 2012) Health, 2010). The strategy calls on healthcare professionals to identify patients that may be in their last year of life and to plan with these patients their future care and death, a process known as advance care planning (ACP).…”