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Choice at the end of life: do we have time to wait?

Following on from the health White Paper, the government last week published two new consultations - on choice and information. Together these could have significant implications for how end-of-life care is delivered.

The consultation on choice, Liberating the NHS: Greater choice and control, focuses on giving patients greater choice over how and where they are cared for. The government's pledge to open up the health care marketplace to 'any willing provider' backs up this commitment. A co-ordinated approach at a local level, involving a range of health and social care providers working collaboratively, is fundamental to reaching this goal.

It is particularly important to increase the range of available care for people approaching the end of their lives. We know that many more people would choose to be cared for, and to die, at home than are currently able, and the consultation proposes establishing a 'national choice offer' for people to receive the support necessary to die at home (including a care home) if that is their preference.

A review to consider when this choice will be introduced nationally will be undertaken in 2013, five years after the publication of the End of Life Care Strategy, which currently guides the commissioning and provision of end-of-life care across England.

We welcome the government's continued commitment to improving end-of-life care and enabling greater choice across England. But why wait until 2013 to make improvements?

In our own work on this subject over the past few years, we have seen many examples of regions working to improve access to supportive care for patients as they near the end of life. It is vital that this energy is not lost.

The King's Fund report, Implementing the End of Life Care Strategy: lessons for good practice, which is published today, highlights some of these examples seen through our work with the Marie Curie Delivering Choice Programme.

We have used the end-of-life care pathway outlined in the strategy – from diagnosis and early discussions of care options, through to bereavement support – as a guide to highlight examples of good practice for commissioners and service providers, so they can consider these when working locally to more effectively meet the care preferences of people nearing the end of life.

At present, end-of-life care is often inadequate in meeting patients' care preferences, and our new report provides the necessary impetus for driving reform at a local level.

The coalition government's pledge to review this choice agenda in 2013 risks stalling the current energy and focus in this area. We would strongly encourage commissioners and service providers to continue the developments they are undertaking now to improve choice for patients at the end of life.