09.05.16
One in three CCGs do not assess end-of-life needs – CQC
Dying patients are being left with no support for their needs, the CQC has warned in a new report at the start of Dying Matters Awareness week.
A survey of 40 CCGs by the CQC found that just 67% said they had assessed the end-of-life care needs of their local populations.
The report also found that only 18% of CCGs had commissioned specialised services for marginalised population groups including people whose social circumstances make them vulnerable, older people and people with a learning disability. This, according to the CQC, could lead to a potential breach of the Equality Act if people did not receive treatment in accordance with their wishes – for instance, if elderly people were admitted to hospital in the last days of their life when they would prefer to die at home.
Professor Steve Field, chief inspector of general practice at the CQC, said: “While we know there are hospitals, GPs, care homes, hospices and community services across the country that are providing good and even outstanding care to people at the end of their lives, one person that does not get this is one person too many.
“Family members that we spoke to told us they felt marginalised because their loved ones did not have the same level of access to services, or felt like they were treated differently to other people receiving end-of-life care.”
He added that a person’s diagnosis, age, ethnic background or social circumstances should not affect the quality of care they receive at any point, but certainly not at the end of their lives.
“What is important is that everyone receives care based on their individual needs, delivered with compassion and sensitivity by staff with the right skills, and that there is regular and effective communication between staff and the dying person and their family,” said Prof Field.
Claire Henry, MBE, chief executive of the National Council for Palliative Care & Dying Matters Coalition, said the CQC report demonstrates the importance of making good end-of-life care priority for everyone.
“To do so, we need to understand people’s needs and priorities, and shouldn’t make assumptions about anyone,” she added. “I hope this report brings about real change, because we are failing as a society if anyone suffers needlessly in their final weeks, days and hours.”
Dying Matters’ seventh annual awareness week begins today.
The CQC has also found that 42% of end-of-life services at acute trusts are rated as inadequate or requiring improvement.
The CQC said reasons for these problems included lack of knowledge of the needs of different groups, end-of-life care that isn’t co-ordinated around the person and difficulties identifying when a person is at the end of their life, meaning that conversations about their needs don’t occur soon enough.
However, the CQC said it had identified areas of good practice, including training projects set up to develop the skills of care home staff and local services developed to meet the end-of-life care needs of specific groups.
Jane Mordue, interim chair of Healthwatch England, said: “Poor end-of-life care denies people a dignified, peaceful death and causes suffering to them and their loved ones. What’s more, it comes at a huge financial cost to the NHS.”
Phil McCarvill, deputy director of policy at NHS Confederation, said: "It is essential that we learn from this report, as well as the annual VOICES survey of bereaved people and the Royal College of Physicians’ clinical audit, all of which set out what needs to be done to improve people’s experiences of end of life care. To address the issues raised, the whole system needs to work together to ensure that we are prioritising end of life care and are putting the wishes of people at the centre of care.”
The BMA recently warned that doctors need better training on treating dying patients.
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