What is ELCQuA?

The End of Life Care Quality Assessment tool (ELCQuA) is an online tool for keeping track of progress in delivering end of life care services, intended to develop a picture of how end of life care is currently delivered and help you to take a look at services in the context of similar organisations locally and across the country.

ELCQuA builds on the recommendations laid out in End of Life Care Strategy: Quality Markers and Measures for End of Life Care, intended as a guide to delivering the best possible care for patients at the end of life. It also links to the NHS Quality, Innovation, Productivity, and Prevention Challenge, the End of Life Care Key Performance Indicators (KPIs) and the Care Quality Commission prompts for end of life care.

• If you are employed by an organisation providing end of life care, ELCQuA can help you keep track of your progress in reaching the aims for your service, as well as showing you what you are doing particularly well compared to other organisations and what you could be doing to make your services better.
• If you are involved in commissioning end of life care services, ELCQuA can help you to be aware of best practice in commissioning and to ensure the best care possible for people approaching the end of life.

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Why has ELCQuA been developed?

In the past, end of life care has often been given little attention compared to other areas of care. As a result, there is in many respects little information about what is being done to provide good care at the end of life, while organisations providing this care have had few readily-available means of keeping track of progress on their priorities and determining best practice.

Providing consistent reporting across a range of organisations, whether an SHA, trust or commissioning organisation, can be quite a challenge and very time consuming. Monitoring progress for a particular programme would often involve an email trail of disparate documents and a significant exercise to gather together all the necessary information from several different sources.

ELCQuA tackles this problem by providing a common environment where analysis is consistent, with a variety of reporting styles available. In only a few mouse clicks it is possible to capture the latest positions of teams across a locality, SHA or the entire country.

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What is being assessed by ELCQuA?

At its core, ELCQuA measures progress against nine key aims in end of life care:

1. People in the community are aware of issues and choices around death and dying.
2. Patients have their end of life care needs planned for regardless of diagnosis or care setting.
3. People approaching the end of life have their needs and wishes identified and communicated to all involved in their care.
4. Patients have access to all of the basic building blocks of care, at short notice and in all care settings, including their own homes.
5. Patients and their families receive uniformly high quality end of life care at all times in all care settings.
6. People in the last days of life are as far as possible free from pain, discomfort and fear, and are treated with sensitivity and dignity, with their wishes respected.
7. People are treated respectfully and appropriately after death, and families are supported by high quality bereavement care.
8. Patients and families are confident that those caring for them at the end of life are well trained, competent, confident and sensitive to their needs and wishes.
9. People see the outcomes of quality assessments of the local end of life care services and evidence of continuing quality improvement.

However, in addition to providing these core standards based on the Department of Health's Quality Markers framework, ELCQuA enables organisations to assess and track their progress relating to any area of care they consider a priority. The tool has the flexibility to add any objectives on a local level as well as providing the means to track progress against national recommendations for best practice.

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Can ELCQuA be used by individual organisations working in isolation?

Yes. Though the functionality of ELCQuA provides a common environment for consistent reporting across a number of organisations, there is no reason why an organisation can't add a programme which just applies to that organisation.

Assessments can also be sub-divided within an organisation so that, for example, commissioners could monitor progress by locality or PBC group. Similarly, a Trust could run a programme of assessments across a number of departments.

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Who uses ELCQuA?

If you work for an organisation that provides or commissions end of life care, you can request access to the system. The tool is specifically aimed at the following organisations:

• Commissioners
• Primary care organisations
• Acute hospitals
• Community services including community hospitals
• Care homes
• Specialist palliative care inpatient facilities
• Specialist palliative care community services
• Ambulance services
• Out of hours services
• Local authorities

Depending on who you are, you will be able to access different parts of the tool. The information you are able to see, upload and update will depend on your role and organisation.

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Why use ELCQuA?

The key features of ELCQuA are summarised as follows:

• Action planning and progress monitoring in end of life care
• Hold evidence on current services in one place
• Investment planning
• Simple traffic light assessments (red, amber, green)
• Flexible analysis
• Report progress
• Real-time updates
• Sharing good practice
• Secure data
• Access from anywhere that has an internet connection
• User friendly and easy to update
• Personalised to each user
• Helps with assessment against the CQC end of life care prompts
• Completely free to users!

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What reports can ELCQuA produce?

At the moment, ELCQuA can create the following reports:

RAG reports: displays the RAG traffic light rating (red, amber, green) for each measure for all of the organisations in a particular group and area. It is possible to customise the report to show just those measures you wish to see.

Team reports: for organisations providing end of life care, a team report provides a detailed list of your progress against any measures relevant to you, including your assessment of your current position and information about any actions needing to be undertaken.

Details on accessing these reports can be found in the ELCQuA guide inside the tool. If you have requests for any other reports or suggestions for changes to existing reports, please be in touch! ELCQuA is there to help you, and we would like to make sure that you are able to reach all of the information you need.

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Who should complete assessments within an organisation?

Anyone registered within an organisation can complete assessments, so whoever is best suited to assess and keep track of progress in a particular area. This may be a project manager, or possibly team members working within relevant roles. It is possible to assign "leads" for individual objectives so that anyone within an organisation can keep track of those aspects of end of life care that are relevant to them.

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How often should organisations repeat the ELCQuA?

As often as you need to! ELCQuA is there to help you keep track of your organisation's progress, and the more complete and up-to-date the information you provide the more useful it is likely to be.

In general, it is recommended that for the core quality markers, you review the status annually. If it seems like a lot to do all of the measures at once, you could consider, for example, doing a quarter of the measures at a time every three months.

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Will members of the public be able to see the self-assessments?

No, ELCQuA is accessible by providers and commissioners of end of life care. Information provided in the tool will be accessible only to those involved with health and social care at the end of life.

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