Press release: NHS Confederation report highlights need to improve care of the terminally ill

12 Dec 2005

The final request of most terminally ill patients is to die in the comfort of their own home - but all too often their dying wish cannot be granted. 

That is the hard-hitting message of a report published today by the NHS Confederation which has five key recommendations to improve the care of the 530,000 people who die in England and Wales every year.
Improving end-of-life care is one of a series of reports being published by the Confederation, which represents more than 90 per cent of NHS organisations, in advance of the forthcoming government White Paper on out of hospital care.

Jo Webber, the Confederation's Deputy Policy Director, says: "According to latest figures from the National Council for Palliative Care, 56 per cent of terminally ill patients would prefer to die at home but only 20 per cent currently do so while only 11 per cent of people want to die in hospital but that's where 56 per cent spend their final hours.

"The 16 per cent of our population who are aged over 65, who already account for 84 per cent of deaths, will increase to 21 per cent by 2024 and so it is essential that the golden opportunity provided by the White Paper to improve end-of-life care is seized.

"Everyone should be able to exercise their right to choose where they die."

Eve Richardson, Chief Executive of the National Council for Palliative Care, says: "Enabling people to die with dignity in a place of their choosing is the bedrock of our response to the government's consultation on out of hospital care and we hope that the forthcoming White Paper will include proposals to make that a reality.

"The NHS Confederation's report is a valuable contribution to increasing public awareness and debate about death and dying and the opportunities we have to make death a better experience."

Improving end-of-life care also highlights the fact that most end-of-life care is weighted towards cancer patients, even though more people actually die of other life-threatening conditions.

According to the Office of National Statistics, 25 per cent of deaths in 2003 were caused by cancer but 44 per cent of people died of heart disease, respiratory disease and strokes.

The National Council for Palliative Care estimates that, while 95 per cent of patients using hospice or palliative care have cancer, 300,000 people with other terminal diseases who might benefit from this care are excluded because of their conditions.

There are five key recommendations to improve end-of-life care in the NHS Confederation report:

• a renewed focus is needed to increase the capacity of home and community care so more people can choose to die outside hospital and emergency admissions to hospital during patients' dying days are minimised
• carers should be treated as members of the health and social care team and the support they are given should be improved by, for example, expanding the role of social and voluntary care to provide respite and night-sitters
• palliative care training should be a core component of all health and social care professional training, and a requirement in all support workers' training, so that generalist staff in hospitals, primary care and care homes have the skills to provide most end-of-life care - with access to specialist support where necessary
• every patient should have their views listened to and have plans made which are based on a full assessment of their physical, social, spiritual and psychological needs
• local strategic plans for end-of-life care need to be agreed by all health, social and voluntary organisations involved in the delivery of care for people in the last stages of life because it requires a joined-up, partnership approach.

ENDS

 

Notes for editors

1. National Council of Palliative Care statistics 2003:
Preferred place of death - Home (56 per cent)
Hospital (11 per cent)
Hospice (24 per cent)
Care Home (4 per cent)
No Preference (5 per cent)
Actual place of death - Home (20 per cent)
Hospital (56 per cent)
Hospice (4 per cent)
Care Home (20 per cent)
2. The NHS Confederation represents more than 90 per cent of the organisations that make up the NHS throughout the UK. Its members include the majority of NHS trusts, foundation trusts, primary care trusts and health authorities in England; trusts and local health boards in Wales; NHS boards and special boards in Scotland; and health and social service trusts and boards in Northern Ireland. 
3. The National Council for Palliative Care is the umbrella organisation for all those who are involved in providing, commissioning and using hospice and palliative care services in England, Wales and Northern Ireland. It promotes the extension and improvement of palliative care services regardless of diagnosis in all health and social care settings and across all sectors to government, national and local policy makers.

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