Improving End-Of-Life Care Needs To Become A Much Greater Local Priority

Improving End-Of-Life Care Needs To Become A Much Greater Local Priority

This week saw the launch of new research showing stark variation in palliative care provision across different services and between different regions in England.

The study published in BMJ Supportive and Palliative Care showed that, worryingly, palliative and end of life care services are not being given the priority they deserve in certain parts of England.

It found that Clinical Commissioning Groups (CCGs) are not using standardised information about their local populations to commission services, resulting in confusion over who is responsible for service provision and effectively creating a "postcode lottery".

The team led by Baroness Ilora Finlay, a professor of Palliative Medicine and also chair of the National Council for Palliative Care (NCPC) was based on Freedom of Information requests to all 209 CCGs in England in 2015.

Among the findings of the research paper entitled: Commissioning of specialist palliative care services in England were that only 16% of CCGs consider end of life care a priority and out of 81 CCG respondents, only 29 provided information about the number of patients with palliative care needs in their population.

This new research chimes with similar research undertaken by Hospice UK last year- also based on a Freedom of Information request - to both CCGs and Health and Wellbeing Boards (HWBs) in England.

Our report A low priority? How local health and care plans overlook the needs of dying people found more than a third (34%) of HWBs did not consider the needs of dying people when assessing the health and care needs of their local populations;

In addition, almost six in 10 (57%) of HWBs did not include the needs of dying people in their key strategies - the same as in 2014 - and more than 1 in 4 (27%) CCGs did not have a strategy for addressing end of life care in their area.

Last summer, the Government published a new National Commitment on End of Life Care which set out the steps that the system would take to improve care at the end of life.

It is apparent that there is still a long way to go to make sure that end of life care gets the attention it deserves in all parts of the country - especially to improve the commissioning of end of life care services.

There are tools available to help CCGs and HWBs take action. The Ambitions for Palliative and End of Life Care provides a valuable framework for local action, and is being used by commissioners and providers to improve the care that people receive.

However, improvements to end of life care will only happen if this type of care becomes a bigger priority among health and care leaders at local level.

Strong, reciprocal relationships between CCGs, HWBs and local care providers - such as hospices - can help achieve positive change and increase awareness about the needs of people at the end of life.

Hospices play a vital role in meeting people's needs at the end of life and have a detailed understanding of the needs that exist within their local communities.

Many CCGs already work closely with their local hospices, but we need to go further to make sure that the whole system works together to improve care for people at the end of life. .

We need CCGs and other local health bodies to take more responsibility to prioritise end of life care. Working together, we have an opportunity to make a real difference to the care that people receive at the end of life, but only if there is the will to make that happen.

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