‘Stunning inequities’ in palliative care

An independent review into palliative care in England has found “stunning inequities” in the levels of treatment for the dying, calling the current system ‘confusing’ and ‘inconsistent’.

Requested by the Government and led by Marie Curie Cancer Care chief executive Thomas Hughes-Hallett, the report proposes a set of guarantees on what the state will provide for patients nearing the end of their life.

The report praises the "many highly committed professionals" who are doing their best, but concludes that thousands of people who need help do not benefit from their expertise. It also argues that fewer than half of people receive the palliative care they require, that a quarter never discuss it and that too many die in hospital, against their wishes.

According to figures from the Department of Health included in the report, in the last financial year one primary care trust spent approximately £186 per death while another spent £6,213.

Hughes-Hallett said: “You get better clinical and economic outcomes when patients receive palliative care. But there is no tariff for this in hospitals or the community so it is no surprise that good outcomes are not achieved. We are left with stunning inequities.”

Simon Chapman, from the National Council for Palliative Care, responded: “Although the majority of us would prefer to be cared for and die at home, in a care home or in a hospice, more than half of us die in hospital.

“We only get one chance to get it right for dying people, which is why it must be a priority to ensure everyone who needs it can access palliative care round the clock.”

And Ciarán Devane, chief executive at Macmillan Cancer Support, said: “It will be up to the Government to ensure that these services are standard across the country. We need to see a massive improvement on the 56% of PCTs who currently provide 24-hour community nursing.”