Barriers between health and social care services, as well as health inequalities, are stopping everyone who needs end of life care from getting it

This article was part of the End of Life Care channel, in association with Marie Curie Cancer Care. The channel is no longer being updated.

Last month the World Health Organization published the first ever “atlas” of care for terminally ill and dying people around the world. Its findings are stark: only one in 10 dying people has access to palliative care.

The UK is a world leader in palliative care − but there is still significant unmet need here.

‘There is growing unmet need in palliative care for people from black, Asian, and minority ethnic communities’

Terminally ill people, their families and carers frequently struggle to gain access to the care they need. The Department of Health Palliative Care Funding Review found that around 355,000 people in England need palliative care each year but around 92,000 people do not receive any.

Location does play a part in this, but research funded by Marie Curie shows inequalities when we look at a person’s diagnosis and their ethnicity.

Troubling trend

Marie Curie funded researchers found that people with a non-cancer diagnosis are less likely to get the care they need − only 20 per cent of people in Scotland who were terminally ill but without a cancer diagnosis could access palliative care.

‘Health and social care services need to listen to people who experience barriers to accessing care and tear these down’

Our recent report in partnership with Public Health England shows growing unmet need for people from black, Asian, and minority ethnic communities. The precise number of people from BME communities not able to access care is difficult to quantify, because data collection on ethnicity tends to be patchy across the health and social care services.

These trends are troubling because there is a forecast growth in the number of people with multiple morbidities and also those from BME communities needing palliative care in future. Demographics mean that the number of people from BME communities needing palliative care will triple in the next 25 years, and with people living longer the number of people dying with non-cancer conditions, particularly dementia, is set to rise dramatically.

Reach more people

The time to act is now. Health and social care services need to listen to people who experience barriers to accessing care and tear these down. We should not let ourselves believe that because the situation in the UK is better than elsewhere in the world that it is universally good for everyone who needs care, because the evidence shows it is not.

We need to ensure that we are reaching more people with a palliative care need each year. That means ensuring the services that we commission meet the actual needs of patients and families − regardless of disease, ethnicity or any factor other than need.

Phil McCarvill is head of policy and public affairs at Marie Curie Cancer Care

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