The first national strategy for end of life care is welcome and I am quietly confident we will see improvements.

The strategy has powerful messages about inequalities. Access and quality vary according to age, diagnosis, gender and geography. The frail elderly, many with dementia, are often disadvantaged. Some die horrible deaths in hospital. In 2007, the Healthcare Commission highlighted that 54 per cent of complaints in acute hospitals relate to care of the dying.

We must roll out palliative care for non-cancer patients and develop choice, with patients enabled to die at home if they want. We must change professional practice by training staff to recognise patients who might benefit from end of life care and we must develop responsive 24/7 co-ordinated services.

Primary care trusts are getting£286m to support all this. High calibre clinical and managerial leadership will be required to forge partnerships with local authorities and the voluntary and independent sectors. An agreed strategy should now be in place everywhere. Every chief executive and NHS board should make an unambiguous commitment to it.

Professor Mayur Lakhani, chair, National Council for Palliative Care