This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.theguardian.com/society/2016/mar/31/end-of-life-care-in-nhs-still-not-good-enough-report-finds

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
End-of-life care in NHS still not good enough, report finds End-of-life care in NHS still not good enough, report finds
(5 months later)
NHS care of people dying in hospital is much better care since the Liverpool Care Pathway was axed, but too many are still not receiving proper palliative care in their final hours, a new report has found.NHS care of people dying in hospital is much better care since the Liverpool Care Pathway was axed, but too many are still not receiving proper palliative care in their final hours, a new report has found.
Those who die overnight or at the weekend may be denied the right care because only 11% of hospital trusts in England provide specialist palliative services around the clock, according to a detailed audit of end-of-life care.Those who die overnight or at the weekend may be denied the right care because only 11% of hospital trusts in England provide specialist palliative services around the clock, according to a detailed audit of end-of-life care.
It found that “a broad front of improvements in nearly all aspects of care of the dying in hospitals” occurred between 2013, when the controversial LCP was scrapped, and 2015. Its findings are based on an analysis of the care of 9,302 patients who died in hospital in England in May 2015.It found that “a broad front of improvements in nearly all aspects of care of the dying in hospitals” occurred between 2013, when the controversial LCP was scrapped, and 2015. Its findings are based on an analysis of the care of 9,302 patients who died in hospital in England in May 2015.
Dr Adrian Tookman, a clinical director at the charity Marie Curie, which co-funded the research with NHS England, said that “there has been a real effort to improve care of the dying in hospital over recent years.”Dr Adrian Tookman, a clinical director at the charity Marie Curie, which co-funded the research with NHS England, said that “there has been a real effort to improve care of the dying in hospital over recent years.”
Related: Doctors may treat dying patients for too long, finds BMA report
For example, staff had discussed the patient’s impending death with their relatives in 95% of cases. And in 54% of cases people close to the patient had had the chance to say what help and support they needed, almost double the 25% who had that opportunity when the audit was first undertaken in 2013.For example, staff had discussed the patient’s impending death with their relatives in 95% of cases. And in 54% of cases people close to the patient had had the chance to say what help and support they needed, almost double the 25% who had that opportunity when the audit was first undertaken in 2013.
However, Tookman added: “We can’t ignore the fact that the vast majority of dying people and those close to them still have limited or no access to specialist palliative care support when they need it in hospital. This is not right, not good enough.”However, Tookman added: “We can’t ignore the fact that the vast majority of dying people and those close to them still have limited or no access to specialist palliative care support when they need it in hospital. This is not right, not good enough.”
“Care of the dying has no respect for time. Round-the-clock availability of specialist palliative care in hospitals should be the norm. When this care is missing, people suffer, and this suffering can live long in the memory of those they leave behind.”“Care of the dying has no respect for time. Round-the-clock availability of specialist palliative care in hospitals should be the norm. When this care is missing, people suffer, and this suffering can live long in the memory of those they leave behind.”
The NHS needs to start recruiting and training doctors and nurses now if it wants to deliver a good 24/7 palliative care service by 2020, “otherwise the problem will only get worse as more people die each year”, said Tookman.The NHS needs to start recruiting and training doctors and nurses now if it wants to deliver a good 24/7 palliative care service by 2020, “otherwise the problem will only get worse as more people die each year”, said Tookman.
Case notes showed that only 31% of patients were reviewed by a member of a specialist palliative care team within 24 hours of admission to hospital.Case notes showed that only 31% of patients were reviewed by a member of a specialist palliative care team within 24 hours of admission to hospital.
The report highlighted other issues:The report highlighted other issues:
Professor Sam Ahmedzai, clinical lead for the audit, which was undertaken by the Royal College of Physicians, said phasing out the LCP, which was widely criticised for treating dying patients too impersonally, had been a “momentous step”. Under the system adopted since, then patients’ wishes are meant to guide the care they need and staff are supposed to talk more openly to them and their relatives under a new “five priorities of care” approach.Professor Sam Ahmedzai, clinical lead for the audit, which was undertaken by the Royal College of Physicians, said phasing out the LCP, which was widely criticised for treating dying patients too impersonally, had been a “momentous step”. Under the system adopted since, then patients’ wishes are meant to guide the care they need and staff are supposed to talk more openly to them and their relatives under a new “five priorities of care” approach.
Related: Four in 10 hospitals told to improve care for the dying
Dr Ros Taylor, the clinical director of Hospice UK, said that, despite improvements since 2013, “it is clear that pockets of very poor palliative care still persist and that some hospitals are offering worryingly little face-to-face palliative care.Dr Ros Taylor, the clinical director of Hospice UK, said that, despite improvements since 2013, “it is clear that pockets of very poor palliative care still persist and that some hospitals are offering worryingly little face-to-face palliative care.
“Dying doesn’t happen 9-5 and people should not be deprived of the vital care they need because of the lack of specialist support available out of hours and at weekends.”“Dying doesn’t happen 9-5 and people should not be deprived of the vital care they need because of the lack of specialist support available out of hours and at weekends.”
NHS England welcomed recent progress but stressed that more needed to be done to ensure better and more consistent care. “Although this audit presents a snapshot of end of life care within NHS hospitals, there are clear variations in the support and services received across hospitals and areas where improvements must continue to be made”, it said.NHS England welcomed recent progress but stressed that more needed to be done to ensure better and more consistent care. “Although this audit presents a snapshot of end of life care within NHS hospitals, there are clear variations in the support and services received across hospitals and areas where improvements must continue to be made”, it said.