A ‘fundamental shift in thinking’ can ensure everybody gets the care and support they need at the end of life, argues Phil McCarvill
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 The channel is no longer being updated.
The delivery of end of life care in England is currently shared by hospitals, hospices, residential care homes, nursing services, families, carers and volunteers. This diversity enables us to meet the different needs and wants of people with terminal diagnoses, but also means that people are likely to have very different experiences of end of life care services.
‘As a first step, the government should introduce free social care funding for those in the last six months of life’
To improve end of life care, we must enhance the quality of all services, in all settings. To help us do so, we must look at a range of data sources to examine patterns, experiences and outcomes in end of life care across different services and localities.
Marie Curie has created innovative new evidence and data tools to help all service providers, commissioners and policy makers identify gaps in end of life care in their area. These include the Marie Curie End of Life Care Atlas, a web based mapping tool which gives commissioners new insight into care provision in their local areas, enabling them to commission services and adjust targets to reflect local need.
Long term challenge
We are also committed to working with the royal colleges to improve initial and continuous end of life care training for doctors and nurses and improve prescribing and pain management for patients at home. Furthermore, we believe NHS England should adopt a standardised approach to reporting spending on end of life care as well as develop outcomes based on key performance indicators.
‘New tools will provide a sound basis from which to fundamentally rebalance end of life care services’
Finally, as a first step, the government should introduce free social care funding for those in the last six months of life. In the longer term, commissioners must grasp the nettle and shift the balance from hospital to community-based care. This will require a fundamental shift in thinking and ultimately in the ways services are funded.
Tools such as the Atlas − alongside the VOICES national bereavement survey, the Nuffield Trust’s reports on social care at the end of life and its independent evaluation of the Marie Curie nursing service − will provide a sound basis from which to fundamentally rebalance end of life care services and help improve outcomes for people at the end of life and their families and carers.
The challenge over the coming years will be to achieve this goal.
Phil McCarvill is head of policy and public affairs at Marie Curie Cancer Care
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