Health Secretary Alan Johnson launched the Department of Health’s ten-year End of Life Care Strategy, with £286 million in new money to help more people to die at home. Opinion surveys of the general public have shown that while the first preference for most people (56-74%) would be to die at home, in practice, however, only around 18% do so. 58% of people die in hospital, 17% in care homes, 4% in a hospice and 3% elsewhere.
This new funding – £88 million in 2009/10 and £198 million in 2010/11 -will mean that by 2011, the Government will have met its 2005 manifesto commitment to double the investment in palliative care. Much end-of-life provision outside hospitals is provided by charities such as the hospice movement and Marie Curie.
Launching the document, Mr Johnson said, “people coming to the end of their lives and their loved ones deserve high quality, compassionate and dignified care, on their own terms. This strategy will help make that happen. Now this increased funding will continue momentum for improvement and help make sure that everyone gets access to high quality palliative care and has choice about where that care takes place.”
Reactions to the strategy
Kings Fund chief executive Niall Dixon said, “For too long our healthcare system has not done nearly enough to ensure that care at the end of life is the best it can be. Too many patients have been denied choice, pain has not be well controlled and relatives have been marginalised. This strategy is a wake-up call – if it is heard we can create a set of services that provide choice and a better quality of care to those approaching the end of life.
“The extra resources are extremely welcome and so is the emphasis on developing new services and learning how they work. The creation of an Intelligence Network is a sensible response to the challenge of developing evidence-based practice in this complex area of care. If this strategy is to make a difference, though, it will need a change in attitudes and priorities – patients should be able to feel comfortable talking openly about how they would like their lives to end both with their families and those providing their care.”
Steve Barnett, acting chief executive of the NHS Confederation, said, “Patients want and deserve the right to choose to die in the comfort their own home, as part of a comprehensive and dignified package of end-of-life care. This strategy is an important and overdue step forward and reflects the views of NHS organisations about the care that should be available.
“We believe improvement will be achieved by developing services in the community and giving NHS staff the necessary knowledge and skills to better care for the dying. Care plans will allow patients to really decide where and how they spend their final days, whether this involves receiving high quality care at home, in hospital or a hospice.”
