End of life care: report, together with formal minutes relating to the report
- Document type
- Corporate author(s)
- Great Britain. Parliament. House of Commons. Health Committee
- Date of publication
- 15 March 2015
- House of Commons papers. Session 2014/15; HC805
- Health Services, Social Work, Social Care and Social Services
- Social welfare
- Material type
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Round-the-clock access to specialist palliative care in acute and community settings would greatly improve the way that people with life-limiting conditions and their families and carers are treated, especially if there were opportunities for professionals to share their expertise with other clinicians. Crucially their expertise should be more equitably available to people with a non-cancer diagnosis, older people and those with dementia, for whom early identification and sensitive discussion and documentation of their wishes is also important.
The situation is unlikely to improve unless clinicians feel confident to identify people who may be near the end of life and to start conversations with their patients about their wishes. Too often, however, staff feel that they lack the confidence, skills and training needed to raise end of life issues with patients, let alone understand the mechanisms available to patients and carers under the Mental Capacity Act 2005 which allow people to make their wishes clear. All staff who provide palliative and end of life care to people with life limiting conditions should receive training in advance care planning, including the different models and forms that are available and their legal status.
Most people who express a preference, would like to die at home but that is made more difficult by the shortfall in community nurses and specialist outreach palliative care. The report strongly recommends that the Government provide free social care at the end of life to ensure that no one dies in hospital for want of a social care package of support. Sustainable, long term funding for the hospice sector also needs to be addressed as part of the Government's response to the Palliative Care Funding Review as does full recognition of the importance of the voluntary sector.
Bereavement support for families should also be included as part of end of life care but availability is currently fragmented and inconsistent around the country. Family members and carers are too often left inadequately supported yet could be helped if there were greater awareness amongst health and social care staff of the impact of bereavement, as well as universal access to bereavement services.
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