Interview with Dr Mark Luciani
Advanced Care Planning deserves more than crisis management
Having earlier conversations about end of life wishes can minimise crisis-led care and improve quality of life, says Dr Mark Luciani. Clinical Lead for Ageing Well, Frailty, Dementia & End-of-Life and Paediatric Palliative Care, (NHS Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board).
But with GPs in short supply, pressures on appointments, and an NHS overrun, many conversations aren’t happening early enough, leading to a perfect storm of poor end of life outcomes for patients.
“As the pressures have increased, you find yourself having to make trade offs and choices that you then struggle to look in the mirror at the end of the day and say, ‘Did I make the right calls?’...
Even if you are the best doctor, you are almost incentivised in the current NHS to do it wrong.”
End of life care in a pressured NHS system
In this heartfelt and brutally honest interview, Mark reveals how the pressure to process vulnerable patients within 10-minute appointments caused him “moral injury,” which led to depression and burnout.
The experience of watching patients who he knew deserved better, filtering from hospitalisation to death register on his GP practice board, haunted him to the point of almost leaving General Practice.
“These conversations are not just for these people and their loved ones, to be able to have that dignified ending to their own stories, it’s for us as well. Because it’s the most meaningful job in the world, but, we can only keep it meaningful if we have those conversations. ”
New, innovative clinical tool vital to improving patient outcomes
With time out to recover, Mark has returned to a new clinical role and is making it his priority to support GPs and their patients to have these vital human conversations; enabling them to discuss what matters to them and tailor their end of life care accordingly.
How is this possible within an increasingly pressured NHS system? Well, watch Mark’s interview and read on to discover more about his innovative new Early Identification Toolkit; deliberately designed to audit practice data and create bitesize pathways to capturing bespoke end of life wishes in an agile and empathetic way.
Finding a best practice solution within an increasingly pressured NHS system requires empathy. Dr Mark Luciani’s Early Identification Toolkit, developed with Dorothy House Hospice, uses a free plugin, that automatically audits practice data.
Download the EOL Toolkit now.
The data it produces helps GPs quickly identify patients who would benefit from advanced care planning conversations earlier, and provides GPs with support to confidently capture personalised end of life wishes in a way that acknowledges the very real pressures within primary care.
This toolkit has the potential to:
Reduce the number of end-of-life crises: distressing and resource-intensive emergencies.
Improve staff and carer morale and patient care.
Increase GP confidence in having end of life conversations.
Identify 1000 more patients needing palliative care across BSW; a 50% increase on current numbers.
Increase death literacy rates across BSW.
