Living and Dying Well: Building on Progress

2 Governance and leadership

10 The establishment of robust systems of governance and leadership has from the outset played an important part in the successful implementation of Living and Dying Well¹. A National Advisory Group, with a membership including NHS Board Palliative and End of Life Care Executive Leads and the Chairs of Living and Dying Well¹ short life working groups as well as representatives from NHS Quality Improvement Scotland ( NHSQIS), NHS Education for Scotland ( NES), the Care Commission and the Scottish Partnership for Palliative Care ( SPPC) was set up in October 2008 with the following remit:

• to ensure that the aims of Living and Dying Well¹ are met in a manner that is sustainable and compatible with quality improvement and patient experience programmes, and based on recognised good practice
• to ensure that governance arrangements are in place to support the implementation of Living and Dying Well¹ and to ensure that its integration with other national initiatives is managed appropriately
• to communicate and link effectively with NHS Board Executive Leads for Palliative and End of Life care to ensure that Board delivery plans for Palliative and End of Life care are implemented and integrated with other programmes
• to agree the objectives and monitor progress of the Short Life Working Groups and to ensure robust communication as these groups develop, to maximise the opportunities and avoid duplication of work
• to advise on guidance and communications to be issued to NHS Boards, Scottish Government Health and Community Care national improvement programmes, the Scottish Primary Care Cancer Group, the Care Commission, the Scottish Partnership for Palliative Care ( SPPC), academic bodies, palliative care networks and key representatives of the voluntary sector, including voluntary hospices, national charities and umbrella bodies.

11 Since then, the National Advisory Group has kept under review the delivery plans of NHS Boards, monitored the progress of all Living and Dying Well¹ working groups and approved a number of outputs and recommendations, and maintained an overview of the activities of the National Clinical Leads and of collaborative work with organisations such as NHSQIS and NES.

12 An Executive Leads Group was established in October 2008 under the direction of the National Clinical Lead for Palliative and End of Life Care to bring together the Palliative and End of Life Care Executive Leads of NHS Boards. This group has met on a quarterly basis and has ensured that all Boards have direct and timely access and the opportunity to contribute to national information and thinking, has provided a forum for the open discussion of complex operational issues, and has helped to promote the sharing of information, policy and good practice among Boards.

13 Dr Elizabeth Ireland's post of National Clinical Lead for Palliative and End of Life Care from March 2008 - July 2010 was crucial to the development and launch of Living and Dying Well¹, and she has played a key role in its successful implementation to date. The National Clinical Lead for Palliative and End of Life Care has visited all NHS Boards to discuss their developments, possible risks and barriers to implementation and progress in the drawing up and implementation of sustainable delivery plans for the future. She has also initiated and maintained contact with a wide range of individuals and organisations throughout Scotland, the UK and beyond, ensuring the comprehensive implementation of Living and Dying Well¹ and its appropriate and ongoing integration with other relevant national initiatives at home and the sharing of policy initiatives, ideas and expertise beyond.

14 The appointment of Dr Peter Kiehlmann as National Clinical Lead Palliative Care eHealth has also made a significant contribution to the implementation of Living and Dying Well¹ and the development of key national policies. Both National Clinical Leads have welcomed opportunities to engage with the Academic Council of Deans regarding palliative care in undergraduate medical education, with NHS Education for Scotland and the General Medical Council regarding palliative care in postgraduate medical education and with the Scottish Government Health Directorates regarding specialist palliative care workforce planning.

15 The Scottish Government will continue to support the implementation, governance and leadership of Living and Dying Well¹ and Living and Dying Well: Building on Progress. The National Advisory Group will continue, under the current chairmanship. As necessary, the membership, remit and function will be reviewed to ensure continued governance of palliative and end of life care in Scotland.