To enable people to die at home, the NHS needs to shift resources so that there are more palliative care services in the community, says Marie Curie’s Jane Collins
This article was part of the End of Life Care channel, in association with Marie Curie Cancer Care. The channel is no longer being updated.
Latest figures in Public Health England’s What We Know Now report show that only 44 per cent of people die in their usual place of residence. Yet data from the latest Office for National Statistics National Bereavement Survey (VOICES) shows us that 88 per cent of dying people who express a preference say they want to die at home or in a care home.
With annual deaths set to increase by 17 per cent by 2030, to almost 590,000 deaths a year, we need to pick up the pace of change if we want to respond to the huge increase in care needs of the terminally ill.
Marie Curie believes one of the ways the NHS can respond is to shift resources so there are more palliative care services in the community. The Marie Curie Nursing Service is one model that has been shown to achieve this shift. Our patients have significantly less need for hospital care, are more likely to be able to die at home, and overwhelmingly report outstanding levels of care.
Evaluation of initiatives
The Nuffield Trust has evaluated over 30 existing community-based initiatives to assess whether they led to a change in service use – particularly a reduction in inpatient hospital activity. Their report, Evaluating integrated and community-based care: how do we know what works, concluded:
“We have been tasked with identifying whether service changes have led to a reduction in emergency admissions and the associated cost to the NHS. The results have been almost overwhelmingly negative. The one exception was Marie Curie Nursing Services for terminally ill patients.”
‘The results have been almost overwhelmingly negative. The one exception was Marie Curie Nursing Services for terminally ill patients’
Marie Curie understands the different needs of individual health economies. We work with local NHS and voluntary sector providers to integrate a range of high quality services that meet the needs of communities – from rural populations to major cities.
Our services enable more patients to die at home, reducing unnecessary and sometimes traumatic hospital admissions and A&E attendances at the end of life, reducing costs and pressure on hospital resources.
We want everyone to be able to have a “good death”, provided with the care they want and need, with support available for them and their families.
Dr Jane Collins is chief executive of Marie Curie Cancer Care