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Care of dying patients still ‘inconsistent’

There is still too much “inconsistency” and “poor quality” in the care of dying patients, according to palliative care experts. 

Dr Jonathan Koffman, senior lecturer in palliative care at King’s College London, said around 500,000 people die in England every year, with around a fifth dying from cancer. 

But he said: “How will we identify these individuals and provide them with impeccable assessment? 

“At the moment there’s too much inconsistency and poor quality care meted out to people at critical moments in their life. They experience poor management of really distressing symptoms. This is not a vocal constituency – often they can’t talk.” 

His colleague Dr Katherine Sleeman, clinical lecturer in palliative medicine at King’s College London, speaking at a discussion held in London about how to replace the Liverpool Care Pathway, called for better end of life training for doctors and nurses. 

In July, NICE drafted new guidance proposals to support end-of-life care in the NHS following the abolition of the controversial Liverpool Care Pathway. 

It aims to place the individual and their loved ones at the heart of decisions surrounding their care by helping doctors and nurses identify when someone is nearing their final few days. 

Dr Sleeman said that there has been inadequate training in medical schools on end of life care, adding that just 19% of NHS trusts have mandatory training on the issue. 

She said: “We should be meticulously assessing people dying – their social situation, who cares for them, where they live, their spiritual and psychological needs. 

Prof Bee Wee, NHS England’s national clinical director of end of life care, added that these can be difficult issues for anyone to think or talk about, whether it’s patients, their loved ones or the professionals caring for them. 

But she added that guidance published last year clearly sets out “how much importance we place on individuals and their loved ones being engaged, supported and empowered to make decisions about their own care”.