Palliative and end of life care is ‘variable and inequitable’ across the NHS in England, says report out today
The report by the Healthcare Safety Investigation Branch examines the quality and consistency of palliative care provided to adults.
Since 2004, and even with a national strategy in place since 2008, numerous publications have highlighted concerns about the limitations of the delivery of palliative and end of life care.
These limitations may be more noticeable in areas where funding for services is limited or where care is being delivered across wide geographical areas.
The report found that Health and care services in England are not always able to provide individualised, equitable and coordinated palliative and end of life care to meet the holistic needs of people and their families.
They are unable to consistently provide what people have been led to expect.
The availability of palliative and end of life care across England is variable and inequitable. This is influenced by the location of third-sector organisations, available charitable donations and NHS commissioning, and workforce shortages.
There is limited, specific guidance to support integrated care boards to identify the palliative and end of life care needs of their populations in line with the expectations of the Health and Care Act 2022, and what could/should be done to address those needs.
Nick Woodier, National Investigator at HSIB, says:
“Conversations about death and end of life care are challenging and emotive but it is crucial that health and care professionals can discuss needs and expectations with their patients and families. They should be supported by a system that provides continuity of care, reassurance, and dignity at what is sometimes a very distressing time. In Dermot’s case, the family felt he ‘did not have a good death despite the efforts of those working with limited resources’.
“Our national investigation findings echo those seen in national publications since 2004; that standards of holistic palliative and end of life care often fall below expectations and that there has been limited progress in improvement. The safety recommendations and actions we have set out are directed towards ensuring palliative care patients receive the best level of care wherever they live in England. Each person, and their loved ones, should have a holistic plan, one that is all encompassing and meets all their needs – physical, psychological, cultural, social, and spiritual.
“We recognise that provision of palliative and end of life care is complex, with multiple organisations involved. However, the need for high standards of palliative care will only increase as the population grows and people live longer. Our investigation has highlighted an urgent gap and has shown where more can be done to ensure those at the end of their life are given holistic, consistent, and compassionate care.
