Strategy aims to improve end of life care for people with cardiovascular diseases

Cardiovascular diseases are the most common cause of death in England, accounting for 30% of all deaths in 2011, although mortality rates have been in decline. As reported by the National End of Life Care Intelligence Network last month, people with a cardiovascular disease are more likely to die in hospital, and less likely to die in their place of choice, when compared with other conditions.

The new Cardiovascular Disease Outcomes Strategy outlines how the NHS Commissioning Board will improve end of life care through the work of the new improvement body, NHS Improving Quality (NHS IQ).

NHS IQ will continue to develop and evaluate the Transform programme in hospitals and improve end of life care in the community through electronic palliative care coordination systems (EPaCCS) – both projects which are being transferred from the National End of Life Care Programme at the end of March. NHS IQ will also continue to run and use the National Bereavement (VOICES) survey as a means of monitoring quality of care at end of life.

The strategy also states that improving end of life care for people with cardiovascular disease will need to involve:

• timely identification of people who are likely to be in their last year of life and planning their care with them
• training key staff in assessment of supportive care needs and advance care planning
• improvement in coordination of care across secondary and primary care interface
• developing information and support for patients and carers.

The strategy identifies a number of other actions to improve outcomes for people with cardiovascular diseases generally, including the recommendation that cardiovascular diseases should be considered as a single family of diseases, so that opportunities to prevent and treat the different conditions are optimal, leading to reduced mortality and morbidity, reduced inequalities in access and outcomes and improved patient experience.

The strategy was launched to coincide with the publication of findings in The Lancet which highlighted the UK’s poor mortality rates, compared with similar countries. The Department of Health has also published a ‘call to action’ to reduce avoidable premature mortality – Jeremy Hunt has outlined his ambition to cut avoidable deaths from the five major causes (cancer, heart, stroke, respiratory and liver disease) and to make life expectancy in England among the best in Europe.