Too Many People Are Dying Without Dignity

This week the Parliamentary and Health Service Ombudsman (PHSO) published a new report Dying Without Dignity featuring a string of shocking cases of poor care experienced by dying people and their families.

This week the Parliamentary and Health Service Ombudsman (PHSO) published a new report Dying Without Dignity featuring a string of shocking cases of poor care experienced by dying people and their families.

It is the latest in a long line of reports drawing attention to failings in end of life care.

Many of the cases are very harrowing to read. For example, a 74-year-old cancer patient who spent his last days in avoidable pain. He was subjected to 14 unnecessary attempts to reinsert a drip which caused him considerable pain and discomfort in his final hours.

Or the family of a 67-year-old man who discovered he had terminal cancer after reading his hospital discharge note.

The tragic cases in this report resulted from a range of different reasons including: poor communication with families of dying people, uncoordinated care and inadequate out-of-hours services.

The report highlights how if action was taken to tackle these issues that end of life care could be improved for up to 355,000 people a year in England.

At Hospice UK we are acutely aware there is far too much inconsistency in the care that dying people and their families, sadly often in hospitals.

Hospices have longstanding expertise in supporting dying people and their families and have a key role to play in helping improve standards of end of life care in hospitals and other settings.

Some hospices are already working in partnership with their local hospital to tackle many of the issues highlighted in the health ombudsman's report. However, we need to strengthen the partnership between hospitals and local hospices to improve care and to reduce the number of people spending their final days in a hospital bed unnecessarily.

Last summer, Hospice UK called on the Government to do just that.

Too many terminally ill and dying people are in hospital with no clinical need to be there and who would be better supported in a hospice or their own home. Hospices can help provide a long-term solution to prevent their unnecessary admission to hospital. Many are working with hospitals to provide alternative care options, including support in people's homes.

For example, hospices such as In one model of care, St Catherine's Hospice in Scarborough is piloting four nurse-led end of life care beds to help facilitate rapid discharge from Scarborough hospital for patients in their last days of life. This has helped increase patient choice, enabling patients to receive high quality end of life care in a hospice setting and has helped reduce unnecessary deaths in hospital.

Woking and Sam Beare Hospices are working with their local hospital- Ashford and St. Peter's NHS Foundation Trust- to increase access to hospice beds for patients who might not traditionally have been considered for referral. The hospice-designated beds are treated like an inpatient transfer from one ward to another, bypassing the usual referral process and all the barriers and delay this can create.

We asked the Government to expand this work by backing a national programme to help reduce the number of people in hospital beds at the end of life by 50,000 each year. This is around a fifth of the number of people in hospital when they die. Our initiative can deliver better targeted care and generate an estimated £80m in savings annually for the NHS.

The health ombudsman's report highlights that now more than ever there is an urgent need for NHS colleagues to work with hospices to radically improve end of life care.

We hope the new Government will take up our offer as a new approach to tackling this issue that can help achieve lasting change.

Dying people deserve nothing less than compassionate, co-ordinated care that meets their needs and wishes and allows them to spend their final moments in peace and dignity with their families. It should not be so difficult to get this right.

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