From 9 April 2015, St Christopher’s End of Life Journal will be published and hosted online by BMJ

All journal articles will be transferred to the new BMJ journal website and our current journal website will close

Existing journal subscribers will need to sign up to the new BMJ site in order to access journal articles as we are unable to share subscriber details due to data protection. We will email all subscribers on 9 April with a quick link to sign up.

If you have any questions, please email:

Penny Hansford, Editor in Chief, St Christopher’s End of Life Journal

End of Life Journal welcomes correspondence

If you would like to comment on any of the issues raised in the journal, or any other aspect of end-of-life nursing, then please contact the Editor, Helen Scott, on

Letters to the editor

Dear Editor

Response to article: Palmer R (2011) Non-invasive ventilation: new challenges for hospice nurses.
End of Life Journal 1(2): 1–6

I read with interest the above article on the challenges that hospice nurses sometimes face with regard to the management of non-invasive ventilation when caring for patients with non-malignant conditions such as motor neurone disease. The article is an honest account of practice, highlighting complex areas of care that many nurses increasingly witness across the palliative care sector. The author raises important issues around knowledge and training for frontline nursing staff and their managers.

The article was written to raise awareness of non-invasive ventilation among adult hospice and palliative care nurses. I would like to acknowledge the wealth of expertise and experience in children’s palliative care. The many neurodegenerative conditions seen in children and young people require complex holistic care and symptom management.

Children’s palliative care nurses and children’s hospices have supported children and young people with non-malignant diseases for nearly 30 years, including conditions where the complexity of care has shifted to include non-invasive and long-term ventilation. Children’s palliative care nursing has attained considerable knowledge and competence and there are robust training and competency programmes in place to support its clinicians. The specialty’s commitment to develop and improve practice is reflected in a recently published ventilation toolkit (Cooke et al, 2011). There is consequently a great deal of knowledge and skill in children’s palliative care that is transferable to the adult palliative care setting.

As young people with complex life-threatening conditions are now living to adulthood, issues around transitional care are being widely debated. It is important to recognise and share knowledge and expertise. In so doing, palliative care will be able to be recognised as a specialty that encompasses all patients, regardless of condition or age.

Helen Bennett, Care Development Manager, Children’s Hospices UK, Bristol. Email:

Cooke A, Harris S, Kenny H, Ruthven T, Widdas D (2011) A Toolkit to Support Ventilated Children and Young People in Children's Hospices. Children's Hospices UK, Bristol

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