Concern over palliative care levels

Black, Asian and minority ethnic groups, those aged over 85 and people living in poorer areas are being failed in the quality of palliative care they receive, according to a report.

In all, thousands of patients are not being given sufficient pain relief and respite, the London School of Economics and Political Science (LSE) said.

Terminally ill patients with illnesses other than cancer are also failing to receive help from specially-trained palliative care staff and less end-of-life care from GPs and district nurses.

Despite more than 70% of deaths being due to other causes than cancer such as respiratory illness, circulatory conditions and dementia, people with non-cancer diagnoses still account for only 20% of all new referrals to specialist palliative care services.

It added that providing palliative care to those that need it could potentially generate net savings of more than £30 million in England, at least £2 million in Wales, more than £1 million in Northern Ireland and £4 million in Scotland due to the reduced need for acute care and fewer hospital deaths.
The report, commissioned by the charity Marie Curie, said some people who would benefit from palliative care do not receive any at all.

It said an estimated 92,000 people in England, 6,100 people in Wales, 3,000 in Northern Ireland and 10,600 people in Scotland who would benefit from palliative care every year but are not currently receiving it.

While those from black, Asian and minority ethnic groups were actually more likely than those of white ethnicity to receive support, they were less likely to consider overall care in the last three months of life to be ” outstanding” or “excellent”. This was the same for people in less deprived areas.

It also pointed to evidence that pain and other distressing symptoms are under-reported by older people and/or under-identified by healthcare professionals, and there is confusion about the role of geriatricians in providing palliative care.

With the number of people aged over 85 expected to more than double over the next 20 years, Marie Curie said the report was deeply concerning and exposes gaps in services along with poor communication and unclear roles and responsibilities.

Josie Dixon research fellow at LSE’s Personal Social Services Research Unit (PSSRU) and lead author, said: “Part of the problem is that palliative care has traditionally been for people with cancer and there is currently a lack of suitable models of palliative care for people with non-cancer and increasingly complex conditions.

“Palliative care can reduce symptoms and pain and help people die where they want to. It can also save money by preventing unwanted and distressing hospitalisations.

“These statistics show that care homes have a growing role in caring for people who are dying, but they need more support from GPs and specialists than currently exists.”

Marie Curie chief executive Dr Jane Collins said: “Everyone affected by terminal illness should have access to all the care and support they need, regardless of their personal circumstances. This report shows that this is not the case and some groups are getting a worse deal than others. We don’t think this is good enough.

“We hope that this compelling evidence is a catalyst for change and used by policy makers and care providers to improve how all people with a terminal illness are cared for in the UK. It has the potential to improve the lives of millions of people, as dying is the one issue that affects us all.”


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