End-of-life strategy pledges 24-hour community care

The government has promised to transform palliative care over the next three years with a £286m funding package to enable more people to die at home.

Adults approaching the end of their lives will be able to access 24-hour home, medical and nursing care through “rapid response” services, thereby avoiding unnecessary hospital admissions.

The NHS End of Life Care Strategy will also require health and social care professionals to undergo training in advance care planning and assessment of people’s needs.

Choice and control

Unveiling the programme today, health secretary Alan Johnson said it would allow the 500,000 people who die in England each year greater choice over where they spend their final days.

Although 58% of deaths occur in hospitals, 17% in care homes and 4% in hospices, surveys show that most people would prefer to die at home.

Care services minister Ivan Lewis explained that people were often unaware of other options and too distressed to make inquiries.

He said the strategy “means for the first time that [service users and their families] can access the quality of care and dignity and compassion they need at that time”, adding that it “chimed with Lord Darzi’s review on the future of the NHS, which is about giving people greater control and choice”.

Communication skills

A year-long consultation found many health and social care staff sometimes lacked the skills needed to deliver “optimal care”.

Skills for Care will be asked to build up workforce development programmes for staff in care homes, hospices, and the community. Key issues will include advance care planning, assessment of people’s needs and preferences, communicating with service users and symptom control.

Professionals will be taught to initiate conversations with people with advanced illnesses about end of life issues such as wills, funerals, and treatment preferences.

The subject of death remains taboo in everyday society and within social care, the report says, which has become a “key barrier” to the delivery of good end-of-life care.

Raising awareness of death

To encourage a more open attitude, the National Council for Palliative Care will lead a coalition of organisations to raise awareness of issues involved in death and dying. Local authority bosses and the General Social Care Council will be expected to take part.