Give patients guaranteed 24/7 care at the end of life

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The existing commitment to improving care at the end of life must be maintained despite the tough financial times ahead, a report from The King's Fund says.

Delivering better care at end of life: the next steps seeks to ensure that end-of-life care remains a priority for clinicians and policy makers. The report, produced following a summit of leaders in end-of-life care, outlines ten recommendations to help give patients high-quality care at the end of their lives and meaningful choices about where they die.

These include the following recommendations.

  • Guaranteeing 24/7 care at the end of life. Every patient should have access to someone who can meet their need for care within one hour of requesting help. Commissioners should build services around the needs of patients and carers, and not on the basis of a 9 to 5 day.

  • Giving professionals the training and confidence to help them talk to patients and carers about the end of life. Ultimately, professionals should aim to provide care they would wish to receive themselves, but professionals often do not find it easy to talk about death and dying. A recent survey of GPs for The King's Fund showed that almost half of the doctors questioned said they would welcome support to help them deal with patients at the end of life. Improving communication with patients should be at the heart of all training.
  • Commissioning for quality and care outcomes. Commissioners should identify the outcomes they wish to see from local providers and the funding available. Working together with providers they need to focus on developing quality services and innovative and flexible ways of caring for people at the end of life, rather than finding the cheapest provider.

  • Establishing a solid evidence-base. Commissioners urgently need more national evidence on cost-effectiveness and evaluations of new models of care so they can have the confidence to make changes.

Dr Anna Dixon, acting chief executive at The King's Fund, said:

'Many people still do not receive the care they need at the end of their lives. The combination of tighter funding for health and social care and an ageing population will put more pressure on services for people near the end of life. There is an urgent need for clinicians, commissioners, users and carers to work together to develop innovative and pragmatic ways to provide care that is responsive to the needs of individuals and their families, and that offers value for money. This is not the time for cutting back, but for investing wisely to increase quality and reduce cost.'

Read the report: Delivering better care at the end of life: the next steps

Notes to editors

  1. Delivering better care at end of life; The next stepsreports the outcomes of the Sir Roger Bannister Summit held at Leeds Castle in November 2009, designed to give focus and direction to the implementation of the National End of Life Care Strategy. Attended by senior policy-makers, clinicians, academics, managers and carers, the summit considered papers by some of the attendees and provides 10 critical actions for taking the strategy forward.

  2. The National End of Life Care Strategy is available to download from the Department of Health website

  3. A survey of 501 GPs was conducted by ComRes on behalf of The King’s Fund; fieldwork was conducted online between 4 and 9 December 2009. Full tables are available on the ComRes website

  4. For further information or interviews, please contact The King’s Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2603. An ISDN line is available for interviews on 020 7637 0185. 

  5. The King’s Fund seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.

  6. Attendees at the summit at Leeds Castle:
    • Dr Rachael Addicott, Senior Research Fellow – The King's Fund
    • Beccy Ashton, Advisor to the Chief Executive – The King's Fund
    • Dr Cathy Burton, Clinical Champion – Modernisation Initiative, End of Life Programme & Macmillan GP Adviser
    • Sir Cyril Chantler, Chair – The King's Fund
    • Lady Chantler
    • Ciarán Devane, Chief Executive – Macmillan Cancer Support
    • Steve Dewar, Director of Research and Innovation – Marie Curie Cancer Care
    • Niall Dickson, Chief Executive – The King's Fund
    • Ian Dodge, Director of Policy Support Unit – Department of Health
    • Professor John Ellershaw, Professor of Palliative Medicine – University of Liverpool and Director of the Marie Curie Palliative Institute
    • Dr Rob George, Consultant in Palliative Care – Guy's and St Thomas' NHS Foundation Trust
    • Rebecca Gray, Director of Communication – The King’s Fund
    • Claire Henry, Director – NHS End of Life Care Programme
    • Professor Irene Higginson, Professor in Palliative Care, Policy and Rehabilitation – King's College London / King's Healthcare Partners
    • Tom Hughes-Hallett, Chief Executive – Marie Curie Cancer Care
    • Tessa Ing, Head of End of Life Care – Department of Health
    • Mark Jennings, Director of Health Care Improvement – The King's Fund
    • Simon Kirk, Director of Strategy – NHS Sheffield
    • Dr Kirstine Knox, Chief Executive – MND Association
    • Barbara Monroe, Chief Executive – St Christopher's Hospice
    • Professor Edwin Pugh, Consultant in Palliative Medicine – North Tees & Hartlepool NHS FT
    • Professor Mike Richards, National Director for Cancer and EOLC – Department of Health
    • Eve Richardson, Chief Executive – The National Council for Palliative Care
    • Bob Ricketts, Director of System Management and New Enterprise – Department of Health