Survey reveals wide variation in end of life care

3 July 2012
The first ever national survey of bereaved people has found wide variation in standards of end of life care.

The survey, which has been published today, also reported that while the quality of NHS end of life care is good, choice is still lacking. It also reported that most people want their loved ones to die at home. 

Around 22,000 people responded to the VOICES (views of informal carers for the evaluation of services) survey which was commissioned by the Department of Health. It was conducted by the Office for National Statistics during 2011 and 2012.

The survey reports significant differences in the quality of care experienced according to the age of patient at death, cause of death and place of death. There was a notable variation in dignity and respect, with hospice care rated highest and hospitals, where most died, the lowest. Bereaved people reported that just 57% of hospital doctors and 48%of hospital nurses always showed dignity and respect.

It also revealed that although seven in ten people wanted to die at home, more than half died in hospital.

The survey also reported that three-quarters of people in England thought the care given in the last three months of life was good, excellent or outstanding.

Eve Richardson, Chief Executive of the National Council for Palliative Care and the Dying Matters Coalition, expressed concern about the discrepancies in standards of care. She said: "We welcome the publication of this important report and hope that it acts as a catalyst to further improving end of life care and the support available to people who have been bereaved.

"Although it is encouraging that three-quarters of people who have been bereaved reported in this survey that the care received had been outstanding, excellent or good, it’s a real concern that the quality of care people who are dying receive appears to vary so hugely, with hospitals performing especially badly. There is absolutely no excuse for not treating people who are dying with dignity and respect, which is why it is disturbing that hospital staff appear to be failing to do this consistently.

"We need a new deal for people who are dying, with mandatory end of life training for all staff and much more done to listen and act upon people’s preferences about where they want to be cared for at the end of life, which for most people is in their home and not in hospital. We only have one chance to get end of life care right, which is why the findings from the National Bereavement Survey need to be acted upon immediately.”

The Government launched an End of Life Strategy in 2008 to improve the care of dying patients, including access to district and community nurses around the clock and funding for staff training.

Care Services Minister, Paul Burstow said: “All people, regardless of their age or condition, should get the best quality care at the end of life.

“The results of this survey will be carefully studied by NHS and social care professionals. It reveals a wide variation in the quality of care across the country. There is more to be done to improve both the way care is coordinated for people in their own homes and the quality of care in hospital.

"We are already working with hospices, the NHS and social care to pilot new ways of working and put in place a secure funding system to support palliative care.

"These results will help health and social care to benchmark the care they deliver and learn from the best."

The 59 questions in the survey addressed a broad range of issues including co-ordination of care, patients' involvement in decisions and support for carers.

More on this story

External link: download the full report from the Office of National Statistics 

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