Press Release - End of Life Care
26 November 2008
Each year around half a million people die in England, three
quarters of whom do so following a period of chronic illness, such
as cancer or heart disease. A report out today by the National
Audit Office found that some people approaching the end of their
life receive a high quality service, but that there is room for
improved coordination between health and social care services in
planning and delivering end of life care.
The provision of end of life care is becoming
increasingly complex, with people living longer and the incidence
of frailty and multiple conditions in older people rising.
Information on peoples’ wishes is often not captured or shared and
a lack of services to support them at home may lead to unplanned
and unwanted admissions to hospital.
In 2006-07, estimated expenditure on
specialist palliative care, though only one aspect of end of life
care, varied considerably between PCTs from £154 to £1,684 per
person who died. While there are no complete data on the total cost
of end of life care, we estimate the cost of caring for the 27 per
cent of people who die from cancer is £1.8 billion in the last year
of their life. The majority of people approaching the end of their
life wish to be cared for outside of hospital, so reducing the
amount of time they spend there unnecessarily could make resources
available to support these people more effectively in their
preferred place of care.
Frontline staff often lack training in
delivering basic end of life care. Only 29 per cent of doctors and
18 per cent of nurses received pre-registration training in end of
life care, and there is a lack of formal training for staff working
in care homes. Positive experiences of care were often linked to
being treated by staff who understood, appreciated and empathised
with the end of life situation.
The Department has raised the profile of end
of life care within the NHS and social care services in recent
years. In July 2008, it published a strategy to improve the care
provided to adults approaching the end of their life by increasing
the availability of services in the community and developing the
skills of health and social care staff. To support implementation
of the Strategy, the Department has committed additional funding of
£286 million to PCTs over 2009-10 and 2010-11.
Tim Burr, head of the National Audit
Office, said:
“Good end of life care should mean
that people are treated with dignity and respect and, where
possible, in their preferred place of care. Some people receive
high standards of care in their final weeks, days and hours, but
others do not. Organisations responsible for the care of people
approaching the end of their life need to improve the planning and
delivery of services, particularly support in the community. There
is scope to make these improvements by using both existing and
planned additional resources more efficiently and
effectively.”
Notes for Editors
- Today’s report examines the current provision
of end of life care services and identifies the potential for
improving their quality. It also highlights the issues that will
need to be addressed in the implementation of the Department of
Health’s End of Life Care Strategy.
- End of life care services seek to identify
and meet the needs of both patient and family throughout the last
phase of life and into bereavement. They include the management of
pain and other symptoms, and provision of psychological, social,
spiritual and practical support. In July 2008, the Department of
Health published its End of Life Care Strategy which aims to
improve end of life care for all adults approaching the end of
their life, including support for their families and carers.
- Specialist palliative care is an aspect of
end of life care delivered by clinicians with specialist training,
such as those working in dedicated palliative care units or
hospices.
- Press notices and reports are available from
the date of publication on the NAO website, which is at
www.nao.org.uk. Hard copies can be obtained from The
Stationery Office on 0845 702 3474.
- The Comptroller and Auditor General, Tim
Burr, is the head of the National Audit Office which employs some
850 staff. He and the NAO are totally independent of
Government. He certifies the accounts of all Government
departments and a wide range of other public sector bodies; and he
has statutory authority to report to Parliament on the economy,
efficiency and effectiveness with which departments and other
bodies have used their resources.
Press Notice 53/08
All enquiries to Mark
Anderson,
NAO Press Office: Tel: 020 7798
7558
Mobile: 07796 937 119