End of Life Care
CARE believes that all human life is intrinsically valuable from birth right until the end of life and therefore an important priority for the health service must be helping terminally ill loved ones both live and die with dignity. This means ensuring they receive access to good quality palliative care at the end of life.
The UK has an outstanding record regarding the quality of palliative care. The Economist Intelligence Unit’s 2015 Quality of Care Index ranks the UK top for palliative care provision out of 80 countries; which follows on from its top scoring in the Unit’s 2010 palliative care index.
However, there is still room for improvement, particularly when patient experience can reveal patchy access to palliative care and varying levels of quality depending on where the individual lives and their personal circumstances. CARE wants to see greater improvement in the accessibility and quality of palliative care in Wales.
In 2012 the Welsh Government consulted on a Delivery Plan for End of Life Care. This plan was published in 2013 and set out its expectations of NHS Wales in the provision of end of life care up until 2016. These expectations included among other things, supporting living and dying well and reducing the distress of terminal illness for the patient and their family.
The plan required the publication of annual reports; the first of which was published in 2014. In its 2014 annual report NHS Wales identified areas for improvement, such as: the need for Health Boards to lower the number of emergency hospital admissions of patients who have already indicated an alternative preferred end of life location, e.g. in a hospice or at home. Similarly, the report suggested that there is a need to better identify and support those with changing palliative care needs and recognised that access to respite facilities for terminally ill young people should improve in the future.
The Welsh Government’s second annual report on end of life care published in 2015 showed continued improvement in end of life care provision in Wales, particularly regarding people’s satisfaction with the care their terminally ill loved ones received. However, some of the areas that were deemed to be needing improvement in 2015 included issues identified in 2014, such as the need to ensure that people die in their preferred location rather than in hospital as a result of avoidable, emergency hospital admissions.
In addition, the 2015 report acknowledged further progress was needed to, amongst other things; ensure that people are “better prepared for their deaths;” and to promote sufficient nursing and care home provision to meet the future needs of the ageing population in Wales. The latter area of improvement is particularly important as, with medical technology advances, people live longer and the need for palliative care at the end of life increases. The report notes:
“We know that in Wales, approximately 32,000 people currently die each year, and that 75% of these – 24,000 patients will require palliative care of some sort. By 2037, the number of deaths each year is predicted to increase by about 10% to 35,000. While the Welsh population overall is due to increase by less than 0.1%, the number of people aged 65 and over is predicted to increase by 40% to more than 878,000”
Questions for Candidates
- Will you commit to fighting for greater Welsh Government investment in palliative care in Wales?
- Will you work to ensure that everything possible is done to understand why ‘emergency admissions’ are occurring and to promote appropriate policy solutions?
- Will you commit to pressing the Health Minister and NHS Wales to both identify and support those with changing palliative care needs?
- Will you commit to pressing the Health Minister and NHS Wales to increase investment in nursing and care homes so that there is adequate palliative care provision in the future?
- Will you commit to pressing the Health Minister and NHS Wales to ensure that people with palliative care needs are identified early?
- Will you commit to pressing the Health Minister and NHS Wales to increase access to respite facilities for terminally ill young people requiring nursing support?