With the need to ease pressures on the NHS topping the electorate’s policy wishlist, improved care for terminally ill people can play a major part in reducing the burden on A&E departments

A recent poll has confirmed that the NHS is the top concern for voters ahead of the general election. Care for the terminally ill will be part of one of the main challenges for the next government: easing pressures on the NHS generally and on A&E departments in particular.

Most people in the last year of life will experience an emergency admission, the majority of which are appropriate. However, if the right community based services were in place to care for terminally ill people, some could be avoided. 

Steps the new government could take to improve care for people affected by terminal illness include:

1. Making social care funds work harder

If the long term goal is free social care for the terminally ill, then existing funding systems need to work more effectively – particularly Fast Track Continuing Healthcare (CHC) and reablement funding. CHC isn’t accessible to all and reablement funding is rarely used by local authorities to care for people at home.

2. Accelerating coordination between services

The Better Care Fund feels like a step in the right direction, but we must take further steps to ensure health and social care services work together. This would help ensure that more terminally ill people experience high quality care in the place of their choice. It might mean pooling health and social care budgets, as recommended by the Barker commission.

3. Improving data on how people are cared for

We still know very little about how terminally ill people use services, particularly non-healthcare services. Commissioners and providers need better information to plan for a future where more of us will live longer with more long term conditions. Eventually, real-time, electronic feedback should become standard in hospices, hospitals, care homes and care at home services.

Regardless of the make-up of the next government, commissioners can effect change now by moving more care for terminally ill people from hospitals to the community. We know more people want to die at home than currently do. We also know that making this shift can lead to cost savings and reduce unnecessary hospital readmissions.

Phil McCarvill is head of policy and public affairs at Marie Curie Cancer Care

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