Commissioning guides
Published 01 December 2011

Guide for commissioners on end of life care for adults

This is an extract from the commissioning guide. The complete commissioning guide is available at

4 Specifying end of life care for adults

Implementation of the NICE quality standard for end of life care for adults is expected to contribute to the following outcomes for people approaching the end of life:

  • Care that is aligned to needs and preferences.

  • Increased length of time spent in preferred place of care during the last year of life.

  • Reduction in unscheduled care hospital admissions leading to death in hospital (where death in hospital is against their stated preference).

  • Reduction in deaths in inappropriate places such as on a trolley in hospital or in transit in an ambulance.

This guide focuses on the following areas of care for people with end of life care needs:

Section 4.1 – identification and assessment (including care planning)

Section 4.2 – holistic support

Section 4.3 – access to services (including co-ordination of care)

Section 4.4 – care in the last days of life

Section 4.5 – care after death

Section 4.6 – workforce