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Coalition of charities warns that end of life care is ‘on the brink’

Author: Tom Moran
26 February 2016

A coalition of leading end of life care charities has published a report showing that over the past year around 48,000 people in England experienced poor care in the last three months of life – 10% of all those who died.

The report, On the brink: the future of end of life care, sheds light on failings in the care for dying people since A review of choice in end of life care (also known as the Choice review) was published in February 2015.

The Choice review made a number of recommendations on how to improve end of life care over the next five years, including establishing a 'national choice offer' – allowing people to choose where they are cared for and where they die – by April 2020 and appointing a responsible named senior clinician for each person nearing the end of life.

But today’s report shows that there is still much to be done to improve end of life care. Underneath the headline figure of 48,000 people experiencing poor care are individual stories, with examples of people being unable to access to social care for help with tasks such as washing and dressing, and many families are still left without professional advice on how to care for their dying relative.

Evidence of this inadequate care and support is present throughout the report, with a number of case studies which demonstrate families’ own experiences of end of life care.

Speaking on behalf the coalition of charities, Lynda Thomas, chief executive of Macmillan Cancer Support, said: "This is an astonishing and dismaying number of people being without the care and support they deserve in their final days.

"No relative or carer should be left feeling that their loved one had experienced poor care at such an important and precious time. It is unacceptable that lasting memories are being tainted by pain being poorly managed."

The report adds that a major consequence of the failings is extra pressure on the NHS: people who die in hospital spend an average of 13 days there. It recommends shifting care from hospitals to home, but cautions that this can only be achieved if the right support is in place.

The charities have urged the government to fully implement the recommendations in the Choice review, particularly the national choice offer, and the report gives a six-point strategy for delivering it.

It includes investment in both palliative care specialists and generalist health and social care professionals, more training for professionals so that they are able to adequately support someone nearing the end of life, and a greater share of the medical research budget directed towards improving care for people at the end of life.

Thomas added: "People at the end of life should be given choice over important issues such as where they spend their final days, and sadly we know that this isn’t always the case. Too often we hear of people being marooned in hospital, because they are not getting the right care at home. Nobody wants to see this happen as it is an appalling situation for the individual and puts strain on the health service.

"A review of choice at the end of life was published last year which set out in detail what needs to be done to improve end of life care. The government in England must now respond to this and commit to improvements in end of life care, without immediate action people will continue to die in distress."

The full report is available on the End of Life Care Coalition website.

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