The Department of Health has unveiled nearly £300m of funding for end of life care and told strategic health authorities to resolve significant skills shortages among staff working in the sector.

SHAs will review training commissioning to make sure staff have the skills to provide patients with the standard of care required under the department's end of life care strategy, due to be released yesterday.

The government is concerned that many health and social care staff have had insufficient training in identifying patients approaching the end of life, communicating with them and delivering "optimal care".

Health professionals will be expected to be part of multidisciplinary teams creating individual care plans reflecting the choices of patients, such as whether they wish to die at home or refuse treatment.

These are to be shared with other parts of the NHS such as out of hours and emergency services.

The DH is calling for a "major workforce development initiative" to address the skills shortage, with particular emphasis on those who do not specialise in end of life care.

It wants to see communications skills training programmes and other initiatives set up.

Primary care trusts will be tasked with reforming commissioning and raising the profile of the issue. They will be expected to adopt an "integrated" approach to planning, contracting and monitoring, reviewing the "availability and quality" of services.

They will also have to work with schools, faith groups, funeral directors, care homes, hospices, independent and voluntary sector providers and employers to consider how best to boost the profile of end of life care.

Social care minister Ivan Lewis said the NHS needed to enable patients approaching the end of their lives to have the "dignity and respect" they needed and wanted.

Speaking before the report was published, Macmillan Cancer Support policy manager Duleep Allirajah warned that a "general upskilling" of staff such as GPs, district nurses and care home staff was necessary.

He said that training clinicians to better prepare patients for the end of their lives should be designed into the medical curriculum and added to continuing professional development programmes or "we'll still have people dying in hospitals inappropriately".

HSJ's End of Life Care Nursing conference is on 23 October

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