End-of-life social care should be free, says review

Service users nearing the end of their lives should receive free social care paid by the NHS, a major government-funded review recommends.

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Service users nearing the end of their lives should receive free social care paid by the NHS, a major government-funded review recommends.

Under the proposals, means-testing would be abolished so that patients can be promptly discharged from hospital and given access to integrated health and social care.

The recommendations are contained in the final report of the Palliative Care Funding Review as part of wider reforms to introduce a national tariff for end-of-life care services.

The exemption to means-testing would be applied to all patients on a new end-of-life register, maintained by local clinical commissioning groups and due to be established under the government’s NHS reforms.

“The government must act on the recommendations contained in the review because evidence shows that incentivising the provision of palliative care leads to better outcomes for patients, supports choice and is the most cost-effective way of using NHS resources,” said Professor Sir Alan Craft, adviser to the review.

The report also said patients should have access to NHS care based on need irrespective of the setting in which it is delivered. It proposes a per-patient funding system which would apply to all adults and children.

“Basing the funding model on a needs classification system would ensure that the funding follows the patient in a fair and transparent way, as the level of funding provided to a service would be determined by the complexity and level of need of the patients,” said Thomas Hughes-Hallett, chair of the review and chief executive of Marie Curie Cancer Care.

The review estimated that 60,000 hospital deaths a year could be prevented by 2021 if the recommendations were implemented. The changes are expected to be cost-neutral, with £180m saved from hospital care to reinvest in the community.

The National Council for Palliative Care said it was vital that the government acted on the proposals, to ensure that people had round-the-clock access to palliative care and could die in the place of their choosing.

Palliative care provider Sue Ryder also welcomed the review but called for suggested date for implementing the new funding system – 2016 – to be brought forward.

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