Health commissioners 'must act early' on end of life care

18 July 2011
New healthcare commissioners should prioritise early action on end of life care to ensure people’s choices are met and to avoid unnecessary emergency hospital admissions, according to advice published this week by the National Council for Palliative Care and the National End of Life Care Programme.

The advice, set out in ‘Commissioning End of Life Care: Act & Early’, follows on from the publication of the independent palliative care funding review report, which revealed “stunning inequities” across the country in end of life care.

End of life care was identified as a national priority following the government’s End of Life Care Strategy in 2008, but despite some excellent progress, considerable variations remain in the quality of care.

The new publication is intended to help ensure new commissioners tackle end of life care early on, and to help support people to be looked after and die in their preferred place of care, usually their home. Although 70% of people say that would like to die at home, more than half die in hospitals, often after unnecessary and expensive trips to A&E departments, resulting in crisis admissions to hospital. According to the National Audit Office, 40% of end of life patients have no medical need to be in hospital.

A series of early recommendations relating to nine key areas are set out in the publication for new commissioning organisations. These include a recommendation that each GP practice identifies people likely to die in the next 12 months, ensuring professionals know how to initiate conversations about end of life care and carry out advance care planning, appointing a clinical commissioning board member to lead on end of life care, and agreeing local priorities for end of life care services.

Speaking this week, Eve Richardson, Chief Executive of the National Council for Palliative Care and the Dying Matters Coalition, said: “Too many people towards the end of their lives are being needlessly admitted to hospital against their wishes, causing unnecessary pain and suffering.

"We only get once chance to get end of life care right for people who are dying, which is why commissioners must ensure high quality end of life care and support is available for all those who need it, where and when they need it.”

Anita Hayes, Deputy Director of the National End of Life Care Programme said: “New healthcare commissioners will doubtless face a full in-tray but there are compelling reasons for prioritising end of life care. There has been considerable – but inconsistent – progress since 2008. We know there are tools and sources of support out there for commissioners to build on that progress. If they tap into that and work with partners they can achieve some quick wins”.

Professor Sir Mike Richards, Clinical Director for End of Life Care at the Department of Health added: “This excellent new publication will help commissioners lay the foundations for providing real patient choice when it comes to end of life care. That will not only help ensure that patients are at the centre of decisions about the type of care and support they want and need, it will also help save time, money and resources which can then be re-directed into NHS services.”

Download 'Commissioning End of Life Care: Act & Early' from  http://www.ncpc.org.uk  or www.endoflifecareforadults.nhs.uk/

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