Advance Care Plan: Planning for your future care

NHS West Kent has launched its new Advance Care Plan, which supports people who want to decide in advance what kind of future and end-of-life care they would like when they become more unwell and less able to care for themselves.

The plan was developed from other national tools, including Planning Your Future Care from the National End-of-life Care Programme. It was put together following consultation with GPs, patients, carers, managers, care home staff, and voluntary sector representatives from across West Kent, including input from “The Big Discussion” event in October 2010 to mark World Hospice and Palliative Care Day.

An Advance Care Plan is a statement of wishes and preferences that are personal to the patient and can be about anything to do with future care. It is an entirely voluntary process and is to be kept and shared with those who are involved with the programme of care, including friends and family. It can cover any priorities or preferences that patients want to include, for example:
- how they might want religious or spiritual beliefs held to be reflected in care;
- the name of a person/ people they wish to act on their behalf at a later time;
- their choice of where they would like to be cared for;
- their thoughts on different treatment and types of care they might want to be offered - or not offered;
- how they like to do things, i.e. preferring a shower instead of a bath or sleeping with the lights on;
- concerns or solutions about practical issues, i.e. who will look after their dog should they become ill;
- their preferences regarding paramedics taking heroic measures (resuscitation) if they were found collapsed.

Dr Bruce Pollington, Medical Director at the Heart of Kent Hospice said: “Discussing the long-terms effects of serious illness or a potential disability is never an easy conversation, but working through an Advance Care Plan with your family, GP, community nurse, care home or hospice staff can give you the peace of mind that you will be in control of your own care, even in the event that you may become unable to make decisions yourself.”

An Advance Care Plan is not legally binding, but if a patient loses capacity to give input into their own care, through dementia or confusion from infection, for example, previously expressed wishes would be taken into account by those trying to act in their best interests.

Completing an Advance Care Plan gives a patient an opportunity to voice what they would like to happen and may stimulate discussion about difficult topics, that can be hard for a healthcare professional or social worker to bring up out of the blue. It can also signpost patients to more formal ways of legally transferring over responsibility for care e.g. Appointing Lasting Power of Attorneys or Advance Decisions to Treat.

GPs and community nurses across West Kent have been sent the discussion booklet, and are urging anyone who would like an opportunity to record their wishes to request a copy. If they would like to discuss in person any of the issues it raises, they are invited to make an appointment with either their GP, community nurse or care manager.

Dr Helen McGee, Consultant in Palliative Medicine and Medical Director at The Hospice in the Weald said “We were proud to work with NHS West Kent in developing the Advance Care Plan booklet which was launched earlier this year. We are now routinely using this with our patients and finding it to be a useful tool, enabling patients to document their wishes about their end of life care. Patients have been very receptive to the booklet and it has been really useful for us in opening up conversations with patients, carers and their families.”

Download a copy of the ACP here|