The End of Life Care Strategy, published by the Department of Health in 2008, identified a number of significant issues affecting dying and death in England:
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Some people die as they would have wished, but many do not. Many people do not die in the place they would choose to; many do not receive quality care at the end of their lives; and there are reports that people have not been treated with dignity and respect
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In the past, the profile of end of life care across the NHS and across society has been relatively low, leading to variability in access to and the quality of end of life care across the country and in different communities
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People are uncomfortable talking about dying and death, meaning that when they come to the end of their lives friends and loved ones are not aware of their preferences
The strategy promotes high quality care for all adults at the end of life in England by providing people with more choice about where they would like to live and die. Similar strategies for the end of life have also been developed in Wales, Scotland and Northern Ireland.
The End of Life Care Strategy announced the formation of a new national coalition – Dying Matters - to support the implementation of the strategy, with a focus on raising public awareness and with an aim to support changing attitudes and behaviours in society towards dying, death and bereavement which have impacted on the experience of people who are dying and bereaved.
The Department of Health End of Life Care Strategy acknowledges that there are many challenges to be overcome to ensure that everyone attains ‘a 'good death’ irrespective of their background.
Everybody deserves ‘a good death’ and this is more likely to be achieved by talking about it early on. Although every individual may have a different idea about what would, for them, constitute ‘a good death’, for many this would involve:
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Being treated as an individual, with dignity and respect
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Being without pain and other symptoms
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Being in familiar surroundings
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Being in the company of close family and/or friends