End of life care inequalities unacceptable, says NCPC

9 May 2016
The inequalities in end of life care shown in the CQC’s thematic review are unacceptable and need immediate remedy, says the National Council for Palliative Care.

 The NCPC is calling on the government to publish its response to 2015’s independent Choice review report on end of life care as a first step to addressing the issue.

An opinion poll by ComRes, commissioned by the NCPC, found that 82% of people in Britain said end of life care for older people and people who are dying should be as much a priority for the NHS as care for newborn babies. The same survey found that only 25% of people agreed that “everyone in the UK currently has access to good quality end of life care” with 55% disagreeing. Younger people were more likely to agree with the statement, ,with 31% of 18-24-year-olds agreeing. Among those aged over 65, only 17% agreed, with 67% disagreeing.

Simon Chapman, Director of Policy and External Affairs for the NCPC, said “it is unacceptable for anyone to receive poor quality end of life care. It is especially troubling that people in these groups, so often overlooked and  marginalised by the rest of society, also suffer poor care at the end of their lives. The government needs to take immediate action to address these issues, starting with a response to the Choices Review.”

The Choices Review What’s important to me. A Review of Choice in End of Life Care was published in February 2015 by the Choices End of Life Care Programme Board, a group of independent experts in end of life care. It was chaired by NCPC Chief Executive Claire Henry. It set out a detailed, comprehensive series of costed recommendations to improve palliative care, with a goal for implementation by 2020.

Says Simon “the CQC has done us all a great favour in publishing this report, and NCPC is glad to have helped them with it. We know what needs to be done to improve end of life care for everybody: this report is yet another reminder of why the government needs to get on with it and publish its plan to improve end of life care. There are challenges ahead in achieving the goals of the Choices Review, but they are achievable.  The British people have made it clear that they see this is as a priority: time for action is long overdue.”

“How we treat dying people says a lot about how we treat the living. End of life care should be core business for the NHS but this report makes it clear that NHS leaders are too often neglecting the needs of dying people. This is why we are seeing such deep inconsistency in people’s quality and experience of care. This report lays bare the ways in which different groups suffer needlessly as they approach death. Dying does not make equals of us all. Many individual caregivers are doing their best, but for excellent end of life care for all we need training, resources, support and above all leadership that sees this as a top priority.”
1) Simon Chapman is available for interview
2) ComRes interviewed 2,085 GB adults online between the 15th and 17th April 2016. Data were weighted to be representative of all GB adults aged 18+. ComRes is a member of the British Polling Council and abides by its rules.
 3) For further information about CQC’s report, “A different ending: Addressing inequalities in end of life care”, please visit: http://www.cqc.org.uk/differentending.
4) In 2014, there were a total of approximately 467,000 deaths in England. Of these 47.4 % died in hospital; 23 % died at home, 21.7 % died in care homes and 5.7 % died in hospices.
5) CQC’s review has been carried out in response to the recommendation made by the Department of Health in its report More Care Less Pathway to examine ‘how dying patients are treated across various settings’.
6) CQC’s review looks at end of life care from identification through to death and bereavement. In particular, it focused on end of life care for the following population groups:

  • People with conditions other than cancer
  • Older people
  • People with dementia
  • People from Black, Asian and minority ethnic groups
  • People who are Lesbian, Gay, Bisexual or Transgender
  • People with a learning disability
  • People with a mental health condition
  • People who are homeless
  • People who are in secure or detained setting
  • Gypsies and Travellers

7) As part of its review, CQC spoke with people with experience of end of life care, carers and representatives from a number of voluntary and community organisations. CQC reviewed existing national data on the quality of end of life care for the specific groups included in the review, and requested information from a sample of 44 CCGs that had a range of geographic and demographic characteristics, and varied in performance. A total of 40 CCGs responded to the request. As part of the review CQC commissioned NCPC, National Voices, and the Race Equality Foundation, to undertake targeted public engagement work in 17 local areas. CQC visited the 17 local areas and spoke to staff, including GPs and people with experience of end of life care, and reviewed people’s case notes. A quantitative and qualitative analysis of all of the evidence collected was then undertaken.

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