A campaign has sought to increase nurse representation on a commission examining end-of-life care services across the UK.
Leading nurses have warned that nursing has been treated as an ‘afterthought’ during the configuration of a team of more than 20 commissioners working on the Palliative and End of Life Care Commission.
When the team was announced last week, it originally included just one member with a nursing background.
It also comprised 11 medical doctors, individuals from the charity sector and MPs.
But since the campaigning of registered nurses Professor Catherine Walshe, Professor Alison Leary and Dr Ben Bowers who highlighted the ‘major gap’ of nursing expertise, two more individuals with a nursing background have been added. Another doctor has also been added.
The commission was set up last year to explore the current state of palliative care services and produce recommendations for addressing the current difficulties and gaps in access to high quality care.
It came after MPs voted in support of The Terminally Ill Adults (End of Life) Bill, that would allow adults in the last six months of their life to be medically assisted to die in England and Wales. The bill will continue to undergo parliamentary scrutiny and still has several steps to go through before any potential law changes.
The three nurses campaigning for increased nursing representation on the commission penned a letter highlighted the ‘missed opportunity to enable nursing expertise to be front and centre’.
Catherine Walshe, Professor of palliative care at Lancaster University’s International Observatory on End-of-Life Care warned that the failure to include more nurses in the commission ‘potentially undermines’ the work and ‘quality of recommendations’ it can make.
‘It is important that nurses are seen as vital experts with knowledge and experience to bring to all such bodies,’ she said.
‘Such repeated failures to engage with those who provide much care within the health service could mean that recommendations face challenges when enacted in the real world.’
Alison Leary, Professor of healthcare and workforce modelling at London South Bank University, said policy decisions should be informed by ‘the extensive experience of nurses in palliative care’.
‘Not utilising the extensive experience of nurses in palliative care who work and research with people who use services and their families on a daily basis seems like a missed opportunity,’ she added.
And Dr Ben Bowers, clinical academic and nurse consultant in palliative care at the University of Cambridge said nurse leaders have a ‘rich insight’ to offer the commission that is different to other healthcare professionals, given the extensive end-of-life care nurses ‘oversee and provide’.
The current nurse members include Dr Karen Harrison Denning, an admiral nurse who works as head of research and publications for Admiral Nursing and Dementia UK.
Professor Catherine Evans is another nurse member and a senior clinical academic in palliative care and nursing. She has a background in community nursing.
Clare Fuller joins the committee with three decades of experience in palliative and end of life nursing, having worked in hospices, the community and acute sectors.
Responding to the nurses’ concerns, Professor Sir Mike Richards, chair of the commission, and commission members Rachael Maskell MP and Baroness Finlay of Llandaff said they were aware of the need for ‘wider nursing commission’ in the committee, but that ‘for various reasons the gap had remained’.
They shared the commission’s plans for a roundtable ‘later in the year’ to seek solutions to ‘the current problems’.
‘It would be helpful if you could suggest some who would wish to participate are facing these challenges, who have suggestions for solutions and who would submit information to us prior to such a meeting,’ they said.
Today the chief nursing officer (CNO) for England, Duncan Burton, and general secretary and chief executive of the Royal College of Nursing (RCN), Nicola Ranger, are joining a meeting in parliament to discuss the Terminally Ill Adults (End of Life) Bill that passed through the commons in November.
Earlier this month, the Health and Social Care Committee called on the government to set out its ‘expectations’ for the ‘level and standard’ of palliative care that should be provided in England.
