Needs of Dying People 'Not a Priority' for Many Local Health and Care Leaders

17/06/2016 17:11 | Updated 17 June 2016

In recent years there has been a string of national reports highlighting persistent failings in care for dying people, whether in terms of the quality of care provided or problems getting the right support.

Half a million people in England will die this year but not all of them will get the care and support they need at the end of life.

An estimated 92,000 people every year in England alone have palliative care needs that are not met - that is almost one in six of all deaths.

Following the much publicised re-organisation of the English NHS - which came into force in 2013 - planning for health and care services in England is now devolved to local level.

The role of Health and Wellbeing Boards (HWBs) and Clinical Commissioning Groups (CCGs) - and the priority they attach to end of life care when developing local service strategies - is therefore essential to driving improvement.

Last month Hospice UK launched a new report looking at how health and social care leaders prioritise and plan for the palliative and end of life care needs of dying people in their communities.

Our report A low priority? How local health and care plans overlook the needs of dying people is based on a Freedom of Information request made to all the HWBs and CCGs in England.

We found that the majority of CCGs have a strategy in place to address palliative and end of life care needs locally. And two thirds of HWBs have conducted a needs- based assessment for people approaching the end of life.

However, our research also showed many local health and care decision-makers are overlooking the needs of dying people in their key needs assessments and strategies - the essential building blocks for shaping services.

Our report found that:

• More than a third (34 per cent) of HWBs do not consider the needs of dying people when assessing the health and care needs of their local populations

• Almost six in 10 (57 per cent) of HWBs do not include the needs of dying people in their key strategies - the same as in 2014

• And more than 1 in 4 (27 per cent) CCGs do not have a strategy for addressing end of life care in their area

Health and care services are currently facing immense pressures. It is clear that HWBs and CCGs face considerable challenges in delivering services, amidst financial constraints and competing priorities.

However, one key action they could take, with no additional cost involved, would be greater collaboration with other organisations.

Working more closely with local authorities and providers, such as hospices, would help HWBs and CCGs better understand the care needs of local people.

As providers, funders and leaders of palliative and end of life care, which work closely with the NHS, hospices have longstanding expertise in supporting dying people and a great deal of knowledge about end of life care in their communities.

For example, hospice data across activities, demographics and outcomes could help underpin planning processes for HWBs and CCGs.

Another key opportunity for CCGs and HWBs highlighted in our report is the Ambitions for Palliative and End of Life Care.

The Ambitions framework calls on HWBs to take a lead and work collaboratively to publish local action plans based on population-based needs assessments.

Local health and care leaders have the opportunity to make a real difference to help improve care and support for people with terminal or life-shortening conditions.

And hospices can be important partners in this, from needs assessments to service delivery.

We hope that that the gaps in planning for end of life care services highlighted by our research will be a catalyst for positive change so that local health and care decision-makers make this a greater priority in the future.

In a modern, caring society, everyone should be able to get the care and support they need as they approach the end of life.

However, this will only happen if more local health and care leaders take the lead and ensure that care and support for dying people and their families and carers is a priority from the outset.