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UK National Audit Office publications

Work in progress: End-of-life care

Study Outline

Studies of public opinion have consistently identified that most people would prefer to receive end-of-life care at home or in a hospice and not in a hospital. However, research shows that far more people die in hospital than would wish to do so. For most people, end-of-life care requires active management of pain and symptoms and general care and support – for both the person at the end of their life and the carer. With appropriate support, more end-of-life care could be delivered in the community, that is, in the person’s normal place of residence (their own home or in a care home) or in a hospice for those with more complex needs. However, many people experience difficulties accessing the services they require in a setting of their choice as they approach the end of their lives.

Whilst there is no single definition of what good end-of-life care is, the Department of Health has identified that it should include treating people as individuals, with dignity and respect; ensuring they are without pain and other symptoms; in familiar surroundings and in the company of close family and friends. In addition to meeting the needs of the person approaching the end of life, good quality end-of-life care should also take into account the impact on carers.

The study will examine: whether effective end–of-life care is being commissioned and provided in appropriate settings and the extent and costs of these services across England; equality and consistency of access; the barriers that certain individuals face in accessing these services; and whether current provision of services is of good quality and respects choice and dignity.

We expect to make recommendations to sit alongside the forthcoming Department of Health End-of-Life Care strategy that will help improve services for people approaching the end of life and their carers.

Publication Schedule

We expect to publish our report in Autumn 2008.

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