Kent County Council: county-wide End of Life Care guide and directory

Kent County Council has produced a major guide to the development of end of life care in the county.  It sets out from a council perspective the wide-ranging partnership work involved in end of life care. It relates this work to the Ambitions partnership goals. There is also a large section of supporting documents and resources. The guide makes clear the council’s ongoing commitment to improving end of life care.


In November 2019, Kent Health and Wellbeing Board produced an update report “End of Life care in Kent”. The report sets out progress Kent has made under the six ambitions, from the Ambitions partnership, identifying progress and gaps. The work was begun in 2017 across a wide range of agencies and updated in 2019.

It sets out progress against the 2017 Action Plan, detailing progress in promoting best practice and with a particular focus on the ESTHER model, which was originally developed in Sweden and moves away from “what is the matter with” to “what matters” to people. This approach is a key building block to improving End of Life Care.

The report also details close working with Hospices in Kent.

Overall the report provides a picture of progress in improving end of Life Care across the County as well as key links and resources.

The key challenge was to improve end of life care across a large, diverse area across a range of partners and agencies.

What has been achieved against the end of life 2017 action plan?

A huge amount of work has been undertaken:

All Kent County Council Older People short stay services are following the National Gold Standard programme for End of Life Care, ensuring consistent practice.

End of Life leads in Older People and Physical Disabilities and Learning Disability. And an End of Life champion in Sensory Services has been identified.

There is a programme of work for Continuing Health Care (CHC) to:

  • Ensure staff understand CHC through training and support
  • Key Performance Indicators have been set and monitored

The Design and Learning Centre continues to embed the ESTHER model across Kent and Medway over the next 5 years and this will underpin Primary Care Networks’ MDT practice. The model moves away from “what is the matter with” to “what matters” to people. This approach allows individuals who use care and support services to become an equal partner in planning their care. The name is based on a real person, whose experiences of the 90s Swedish social care system formed the foundations of this way of thinking. To date across Kent and Medway 1700 people are trained as ESTHER ambassadors and 78 ESTHER coaches. Discussions have taken place with Pilgrims Hospice in East Kent around raising awareness of the ESTHER philosophy with the management team and to also deliver ESTHER training to staff and volunteers at the 3 sites.

Proposals for ESTHER Cafes looking at experience of end of life care services are being developed with involvement from the Hospice. Working with East Kent Hospice to implement ESTHER philosophy.

Kent County Council held an event with Health, care providers, hospices and voluntary organisations in 2018 to review progress across the whole system and identify opportunities to improve joint working.

Kent County Council have actively been involved in developing End of Life Strategies with CCGs in Kent.

Five GP surgeries in East Kent will be taking part in a pilot project on Frailty to review whether a pathway is in place and actively being used. KCC is supporting work on Frailty by providing a support officer.

End of Life training is available to social care staff.

Social care participates in Multidisciplinary Teams (MDTs) across Kent to ensure that we continue to work in partnership with Health and that everyone in someone’s care is involved.

The Design and Learning Centre for Clinical and Social Innovation has developed the Hub to respond to the workforce challenges within the care sector. The Hub supports the Care Sector across Kent and Medway to improve quality in care, identify recruitment and retention solutions, provide training opportunities and seek out innovation. End of Life care was part of the Registered Managers conference in March 2019.

KCC is part of the 5 year project test and learn from the Transforming Integrated Care in the Community (TICC) Buurtzorg programme to inform new ways of working and improve quality in care. This highly acclaimed and evidenced based model has transformed the way in which community health and social care has been integrated and provided in the Netherlands.

Social care contributed to the development of the Learning Disability training programme to increase staff skills to enable people to meet their wishes at end of life, which was evaluated in May 2019.

The multi-disciplinary and multi-agency approach, across all sector is a cornerstone of improving End of Life Care