1.4 Identify the key people and services who may be involved in delivery of end of life care

This guide will help you answer 1.4 Identify the key people and services who may be involved in delivery of end of life care.

End of life care is the support given to individuals who are in the last phase of their life due to an advanced, progressive illness. The main goal is to provide comfort and maintain quality of life while addressing physical, emotional, psychological, and spiritual needs. This care is not just for the person who is dying, but for their family and those close to them as well.

There are many professionals and organisations involved at this sensitive stage. Each one plays a key part in providing the best possible care and support. Knowing who these people and services are helps create a coordinated and compassionate approach.

Key People in End of Life Care

Many people work together to deliver end of life care. They each have their own roles and areas of expertise, ensuring that all needs are met.

The Person Receiving Care

Every process starts and ends with the individual who is dying. They are the central focus. Their wishes, needs, and preferences shape care decisions. Listening to their voice is fundamental.

Family Members and Friends

Family and close friends offer vital emotional support. They may help with physical care, decision-making, and comfort. Families need support and clear information to help them cope and participate in the care process.

Key Professionals

Let’s explore the professionals involved, what they do, and why their roles are important.

GPs (General Practitioners)

GPs are often the main point of medical contact. They:

• Assess symptoms and manage pain
• Adjust medication
• Provide advice on treatment options
• Monitor changes in condition
• Communicate with other professionals
• Support the person and their family

A GP helps to coordinate care, especially for people who remain at home.

Community Nurses

District or community nurses visit people at home or in care homes. Their roles include:

• Managing medication
• Checking for pressure ulcers
• Providing clinical care such as wound care or injections
• Supporting families with practical nursing skills
• Building trusting relationships with the person and carers
• Coordinating with GPs and other services

They are crucial in maintaining comfort and dignity.

Specialist Palliative Care Nurses

These nurses have expertise in controlling complex symptoms and providing emotional support. They work in:

• Hospices
• Hospitals
• The community

They may be called “Macmillan nurses” or “Marie Curie nurses”. They support everyone involved, offering advice and training to other professionals too.

Hospice Doctors

Hospice doctors are specialists in palliative medicine. They:

• Provide expert assessment and symptom control
• Give specialist medication
• Offer advice about complex cases
• Train and support other teams

These doctors are usually based in hospice settings but may work in hospitals or visit people at home.

Care Workers

Care workers (sometimes called care assistants or support workers) provide hands-on support for daily living activities. They help with:

• Washing and personal care
• Eating and drinking
• Moving and positioning
• Companionship and comfort
• Emotional support

Care workers are present in care homes, hospices, and people’s own homes.

Social Workers

Social workers support people and families with practical, legal, and emotional matters. Their tasks can include:

• Arranging financial help and benefits
• Advising on housing needs
• Helping with assessments for funding
• Providing emotional support and counselling
• Linking up support services

Social workers help people make choices and understand their rights.

Occupational Therapists

Occupational therapists help people maintain independence during end of life. They:

• Suggest adaptations to the living space
• Advise on equipment for mobility or self-care
• Teach techniques to make daily tasks easier
• Support carers with safe moving and handling tips

Their work can help people stay at home for as long as possible, maintaining dignity and comfort.

Physiotherapists

Physiotherapists help people manage pain and remain comfortable. Their input includes:

• Developing exercise or stretching routines
• Teaching gentle movements for joint flexibility
• Advising on ways to prevent stiffness or sore skin
• Supporting breathing and relaxation techniques

Their goal is to ease discomfort and promote comfort at each stage.

Pharmacists

Pharmacists ensure safe and effective use of medication. Their responsibilities are:

• Advising on the best medicines for pain and symptoms
• Preventing or advising on side effects
• Guiding how to store and administer medicines at home
• Ensuring repeat prescriptions are processed on time

Pharmacists often work closely with GPs and nurses.

Chaplains and Spiritual Leaders

Spiritual care is important for many people at end of life. Chaplains or leaders from different faiths:

• Offer spiritual support, prayer, or religious rites
• Listen to concerns and worries
• Support people of any or no faith
• Help with rituals or customs

Support is shaped by the person’s beliefs and preferences.

Counsellors and Bereavement Support Workers

Facing death can be emotionally overwhelming. Counsellors help with:

• Talking through fears, worries, or regrets
• Managing anxiety or depression
• Listening without judgement
• Preparing for loss
• Providing bereavement support to families after a death

They work in hospices, GP practices, and charities.

Volunteers

Volunteers provide practical help and companionship, making a real difference to individuals and families. They might:

• Sit with someone so carers can have a break
• Offer transport to appointments
• Provide social contact
• Carry out small household tasks

Many hospices and charities recruit and train volunteers for these roles.

Key Services in End of Life Care

Support can come from a wide range of services. Below are the main areas to consider.

Hospice Care

Hospices specialise in supporting people with terminal illness. They provide:

• Symptom management
• Pain control
• Counselling for people and families
• Short-term respite care
• Day care and activities
• Support at home (hospice-at-home services)

Hospices are not only for the very end of life. People may be admitted for help with symptoms, then go home again.

Hospital Services

Hospitals have palliative care teams who can:

• Control severe symptoms
• Offer rapid assessment and treatment
• Support in making decisions about ongoing care
• Liaise with community teams for discharge planning

These teams include doctors, nurses, therapists, social workers, and spiritual advisers.

Primary Care Services

Primary care includes GPs and community nurses. Most people wish to spend their last days at home. Primary care services give regular monitoring and support for this choice.

Community Palliative Care Teams

These are multi-professional teams visiting people at home. They provide:

• Advanced symptom management
• Emotional and psychological care
• Training and advice for family carers
• Support in planning for deterioration

They work closely with GPs and other services.

Out of Hours Services

Emergencies can happen at any time. Out of hours services supply:

• Medical advice and visits outside normal hours
• Palliative support during evenings, nights, and weekends
• Access to urgent medication

People feel reassured knowing help is available when needed.

Home Care Support

Home care agencies provide care workers who assist with personal care needs at any time of day. They help with bathing, dressing, eating, and moving around.

Home care services often work alongside district nurses and GPs.

Care Homes

Some people spend their last days in care homes or nursing homes. These services provide:

• 24-hour personal care
• Nursing care for those with complex needs
• Social and emotional companionship
• Support for families, including visiting and flexible arrangements

Care home staff receive training in palliative and end of life care.

Specialist Charities

National and local charities are valuable in supporting people at end of life. Leading organisations include:

• Macmillan Cancer Support
• Marie Curie
• Sue Ryder
• Hospice UK
• Age UK
• Alzheimer’s Society

They offer counselling, advice, financial help, volunteer support, and information.

Local Authority Adult Social Care

Local councils arrange practical social care support, such as:

• Personal care packages
• Equipment or adaptations
• Emergency respite services
• Direct payments for self-directed care

Social care teams work closely with health professionals.

Psychological and Mental Health Services

People coping with terminal illness may experience distress, depression, or anxiety. Mental health services offer:

• Assessment and counselling
• Psychiatric support if needed
• Help with understanding and accepting prognosis

Referral to these services is through the GP or hospital team.

Spiritual and Faith-Based Services

Community faith organisations and hospital chaplains help people discuss spiritual or religious concerns. They support both individuals and families during this time.

Ambulance Services

Ambulance crews help with urgent transfers between home, hospital, or hospice. They can respond to crises such as pain or sudden illness, ensuring comfort and dignity during travel.

Working Together: Communication and Coordination

To give the best care, everyone must work together. Good communication stops mistakes, repeats, or delays.

Key steps include:

• Sharing information using secure systems
• Holding multi-disciplinary meetings to discuss care
• Recording wishes and preferences (advance care plans)
• Regularly reviewing care as needs change
• Involving families in all discussions

Clear communication allows everyone to support the person in the way they want.

Advance Care Planning and Advocacy

Advance care planning means discussing and recording a person’s wishes for care at end of life. Professionals such as nurses, doctors, and social workers can help with:

• Making decisions about resuscitation or hospital admission
• Deciding where someone would prefer to die
• Setting out key contacts and emergency plans
• Advocating for the person’s choices

Some people need a formal advocate if they have no family or close friends.

Supporting Families and Carers

Looking after someone at end of life is challenging and tiring. Family carers need:

• Clear information and training
• Emotional and practical support
• Time to take breaks (respite care)
• Help after the person has died (bereavement support)

Carers may be offered an assessment to see what help they need. Social care, charities, GPs, and specialist nurses all help to support carers.

Final Thoughts

End of life care is about much more than managing physical symptoms. It means recognising each person’s wishes, respecting their dignity, and offering comfort to both them and their loved ones.

There are many people and services involved. From health and social care professionals to charities, volunteers, and faith leaders, each has a unique role. They come together to make the end of someone’s life as peaceful and comfortable as possible. Knowing who to involve and when helps create a compassionate, joined-up approach to care.

If you work in health and social care, take time to get to know the different people and services available. Build strong links, listen carefully to the person and those around them, and do your part in making this important time the best it can be. Your understanding and actions make a real difference to the lives of people at the end of life and those who care for them.