For Dying Matters Awareness Week, I wanted to reflect on the importance of Advance Care Planning and the impact this work can have for patients, families and the wider healthcare system across Newham.
As the Advance Care Planning Nurse within Newham Community Health Services at East London NHS Foundation Trust, my role is centred on supporting people to have open, honest and compassionate conversations about their future wishes and priorities for care. These discussions can often be difficult, but they are essential in ensuring people feel heard, respected and empowered at one of the most vulnerable times in their lives.
A key part of my role is ensuring patients have an up-to-date and detailed Universal Care Plan (UCP), with their preferred place of care and death clearly documented and shared across services. Through collaborative working with patients, families, district nursing teams, hospices, GP's, hospital teams and community services, we aim to provide coordinated, person-centred care that reflects what matters most to each individual.
Alongside advance care planning, I support timely hospital discharges and work to prevent avoidable readmissions by strengthening communication between primary and secondary care. This includes working closely with multidisciplinary teams, facilitating fast-track discharges, supporting care homes and community nursing teams through education and training, and offering ongoing support to patients and relatives during periods of rapid change.
Over the past six months, the service has achieved significant outcomes, including 98.3% of patients dying in their preferred place of care and strong compliance with UCP documentation standards. These achievements reflect the dedication of the wider multidisciplinary teams across Newham and the shared commitment to improving end of life care for our community.
Dying Matters Awareness Week reminds us that conversations about death and dying are not just about planning for the end of life - they are about dignity, choice, compassion and ensuring every person’s voice is heard.