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The University of Southampton
Health Sciences

End of Life Care

Over the last four years we have worked closely with clinical colleagues to enhance the end of life care provided to people across the South Central area of the country, in partnership with NHS South of England Central.  During the period of organisational restructure in the NHS we are hosting the end of life care resources and toolkits developed through this work. If you have any questions or queries about these resources, please contact:

Section 1: Meeting people's end of life care needs

1. A Practical Guide for GPs - Meeting People's End of Life Care Needs

The End of Life Care team have worked with the Local Medical Committee to produce this simple practical flowchart to help GPs identify those nearing the end of life. It identifies the steps that need to be taken to help address patient and family needs, such as advanced care planning and DNA CPR orders. The flow chart is embedded with web links to the forms that might be needed and to sources of training that can be accessed.  Please note that the link to the DNA CPR forms will take you to those used in the previous NHS South Central area only.

Download A Practical Guide for GPs (pdf) at the side of this page.

2. Caring for People in Care Homes - End of Life Care Toolkit

This toolkit is designed to support the development of end of life care in care homes.  The toolkit includes practical tips about how to improve day to day care as well as tips about the changes needed at an organisational level and the support available for this work. Although specifically designed for care homes the toolkit will be relevant for all social care services including domiciliary care agencies and staff and extra housing schemes.

Download the End of Life Care Toolkit (pdf) at the side of this page.

3. Guide for Care Homes about When to Call an Ambulance - Think!

Knowing when to call an ambulance when someone is at the end of life and in a care home can be a difficult decision - on the one hand wanting to make sure that the person gets the best possible care and on the other respecting the fact that the care home is familiar to them, their home and that they may want to stay where they are. Think! Is a practical diagram to guide designed to guide you through this decision.

Download the Think! (PDF) at the side of this page.

4. Caring for Children and Young People at the End of Life

Providing good end of life care for children and young people depends on good co-ordination and decision-making with numerous health and social teams and with schools and other agencies. Ensuring that everybody knows what decisions have been made is facilitated by advance care planning. The following documents can be used for emergency care planning, a resuscitation plan or an end of life care plan.

Download the Child and Young Persons ACP Form and Policy at the side of this page.

Section 2: Making and Recording Resuscitation (DNA CPR) Decisions

At the beginning of 2010 the NHS South of England Central End of Life Programme Team produced a new DNA CPR policy for South Central. This was the first unified region wide policy in England. It provides clear guidance for local NHS staff and others providing end of life care about when resuscitation should and should not take place, taking into account the wishes of patients.

Here you will find details of the policy, the associated documentation, the resources needed (such as message in the bottle), information leaflets, decision making guides, communication forms and training resources.

1. Adult DNACPR Policy

Download Adult DNACPR Policy v2 (pdf) at the side of the page.

2. uDNACPR  printed form v6

Download uDNACPR Printed Form V6 & Instructions (pdf) and the DNACPR Document re-order information v2 (pdf) at the side of the page.

3. DNACPR decision-making

Download Decision Making Framework v2 (pdf) at the side of the page.

4. Patient information leaflet

Download DNACPR Patient Info leaflet v2 (pdf) at the side of the page.

5. DNA CPR decision making when the patient lacks mental capacity

Download the MCA Leaflet (pdf)

6. Informing others that a DNACPR decision has been made

a. Informing ambulance service (SCAS)

Download DNACPR Informing SCAS V2 and via email (pdf) at the side of the page.

b. Flagging decision to other services

Download Warning Flag Fax template (pdf) at the side of the page.

c. Message in a bottle scheme

Download Message in Bottle Key Contacts (pdf) at the side of the page.

7. Preparing nurses to make DNA CPR decision - training details

Download uDNACPR Nurse-led Competency Documents (Word) and the Nurse Competency training presentation (ppt) at the side of the page.

Section 3: Advance Care Planning

Advance care planning is a key element of the End of Life Care (EoLC) Pathway and a key element of EoLC Quality Innovation Productivity and Prevention work. It is an essential part of the national, regional and local EoLC Strategies.

Advance Care planning ensures that people's wishes are known so that they can receive the care they wish in the location of their choosing where possible.

This toolkit has therefore been developed by SoE Central. It incorporates different National guidance available from the National EoLC Programme putting it all in one place for easy reference.

Download the Advance Care Planning toolkit (pdf) at the side of the page.

Section 4: Tissue Donation

Tissue Donation can be an important part of Advance Care Planning. Nearly everyone can be a tissue donor should they it is important that people are given an opportunity to express their wishes about their end of life care so that these can discussed with their family and their care provider.  Detailed guidance on tissue donation can be found in the document and presentation below.

Download Tissue Donation Guidance (pdf) and Donation presentation (ppt) at the side of the page.

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