Councillor Aspinall (Cabinet Member for Health and Adult Social Care) introduced the Palliative and End of Life Care item and discussed:

a)    The item had originated from a Motion on Notice brought to Full Council in March 2025. Due to the complexity of the subject, it had been referred to the Health and Adult Social Care Overview and Scrutiny Committee for detailed consideration. Members were asked to consider the original motion alongside a written statement submitted by Councillor Beer.

Chris Morley (NHS Devon ICB) added:

b)    Progress was continuing against the locality delivery plan for end of life care in Plymouth and West Devon. The End of Life Steering Group continued to meet regularly and was aligned with the wider Devon Integrated Care Board (ICB) programme to improve end of life experiences across the region;

c)    Progress had been made against the previously agreed improvement plan, with most actions marked as complete or underway. Key developments included:

                         i.        Expansion of the end of life register into an integrated care planning system linked to the Summary Shared Care Record;

                        ii.        Establishment of a central information point for individuals and system partners, supported by St Luke’s Care Coordination Hub;

                       iii.        Completion of demand and capacity analysis, now informing the Devon commissioning plan;

                       iv.        Completion of service options appraisal and audit of care processes;

                        v.        Reallocation of training resources from the Hive system to broader management and leadership training for care providers;

                       vi.        Continued development of the Compassionate City programme and work on death literacy.

d)    A significant reduction had been observed in the number of deaths occurring in hospital, particularly at Derriford Hospital, indicating progress in supporting individuals to die in their preferred place of care.

Laura Daniel (Interim Cluster Manager, University Hospitals Plymouth NHS Trust) provided an update on the end of life pathway at Mount Gould Hospital and discussed:

e)    The pathway had expanded to 12 beds, operating at approximately 90% occupancy to ensure availability for urgent admissions from the Emergency Department (ED);

f)     Over 420 patients had been supported since the pathway’s inception, with positive feedback from patients, families and staff;

g)    Integration of the Marie Curie team had strengthened communication and coordination between acute and community teams. Governance and scrutiny processes were in place to ensure continuous learning and improvement;

h)    The pathway aimed to support patients with both short-term and longer-term needs, recognising the therapeutic value of the environment;

i)     The ED team had focused on preventing unnecessary conveyance to hospital, and Plan-Do-Study-Act (PDSA) cycles were being used to track service improvements;

j)     Work was ongoing to embed Electronic Treatment Escalation Plans (ETEPs) and advance care planning across the Trust.

Tricia Davies (St Luke’s Hospice) provided an update on the Care Coordination Hub and discussed:

k)    The Hub had launched in April 2025 following public consultation, and aimed to provide a single point of contact for patients, families and professionals navigating end of life services;

l)     The Hub offered rapid response, shared decision-making, specialist advice, and support with TEP discussions. It had received 319 calls in its first six weeks, primarily from family carers, patients, district nurses and GPs;

m)  The Hub worked closely with South Western Ambulance Service NHS Foundation Trust (SWAST) and University Hospitals Plymouth, with daily contact to coordinate care and prevent unnecessary hospital admissions;

n)    The service aimed to ensure that patients were supported to remain at home wherever possible, with rapid deployment of St Luke’s response teams;

o)    The Hospice continued to hold learning events when care fell short, and worked collaboratively with system partners to improve outcomes.

The Panel discussed the written statement submitted by Councillor Beer, which expressed concerns about the quality of end of life care and suggested that services were failing. Members acknowledged the emotional nature of the statement and the historical context, particularly during the COVID-19 pandemic. Members expressed disappointment that Councillor Beer had been unable to attend the meeting, and noted that many of the concerns raised in the statement had since been addressed through the improvements presented.

p)    It was acknowledged that services did not always get it right, but that robust governance and learning processes were in place to address shortcomings;

q)    The Committee discussed the distinction between palliative care and end of life care. It was noted that palliative care could extend over months or years, and that care planning should reflect the full trajectory of a patient’s condition;

r)    Members requested further information on integrated care pathways (ICPs) for palliative care, including how care planning addressed nutrition, mobility and holistic needs;

s)     Members agreed that the improvements made over the past 12 months had been substantial and commended all partners for their work.

The panel agreed:

1. To note the progress made against the original Motion on Notice;

2. That no further reports on this topic would be scheduled unless new evidence of concern emerged;

3. To thank all partners for their continued work and commitment to improving end of life care in Plymouth.

Action: Officers to provide further detail on integrated care pathways for palliative care, including care planning for patients not in the final days of life.

Action: Councillor Aspinall to write to Plymouth’s three Members of Parliament requesting support for additional funding for palliative and end of life services.