Peter Crutchfield on the end-of-life experience

For the last 60 years, Marie Curie Cancer Care has been the UK's leading provider of specialist end-of-life care.

We believe everyone should have the choice to be cared for in the comfortable and familiar surroundings of their own home.

Marie Curie nurses provide high-quality care day and night, to support carers and allow them to get a good night's sleep.

As chief executive Thomas Hughes-Hallett recently put it: 'My great hope is that before long, we will witness a major step change to the way end-of-life care is delivered in this country, and as a result, many more patients will be supported to make the choice over where they die.

'For each patient, we only have one chance to get it right.'

Reaching out

This year, the charity will care for around 25,000 terminally ill patients in the community and in its hospices. While we are reaching a significant number of patients, we are not reaching enough.

Our research shows 64 per cent of people in the UK would choose to be cared for at home if they were terminally ill. But only a quarter of cancer patients get that wish, with twice as many dying in a hospital bed.

But Marie Curie nurses don't just make clinical sense. Research shows that for every£1 spent on care for terminally ill patients at home,£2 could eventually be freed up elsewhere in the NHS.

Our Supporting the Choice to Die at Home campaign was launched in 2004 to lobby the government for an increase in palliative care spending. The campaign aims to raise awareness of the issues around end-of-life care, encourage change and show that boosting services to terminally ill patients makes common, as well as financial, sense.

In 2005, the government's election manifesto promised to double the investment in palliative care. Our campaign supports the government in achieving this aim and helps more people die where they wish.

Delivering choice

The Delivering Choice programme was launched in October 2004. Five projects have been launched to date, in Lincolnshire; Tayside; Leeds; Barnet, north London; and south east London. Each is supported by significant charitable funding from Marie Curie Cancer Care.

Each project is a partnership between all statutory and voluntary-sector agencies involved in the provision of end-of-life care. In addition to supporting cancer patients, each project aims to improve access to palliative care services for non-cancer patients.

As the success of these projects is assessed, we will work towards rolling the programme out nationally with the aim of doubling the number of patients who are supported to die at home in the UK.

Impact on families

A total of 612,000 people die in the UK every year. Our Marie Curie nurses care for half of the cancer patients who die at home.

The choice to die at home was a reality for 73-year-old John Hall, from Gainsborough in Lincolnshire, thanks to the Delivering Choice programme's Lincolnshire project.

John had cancer of the brain and his main carer was his friend of 30 years, Kenneth Woolley. Thanks to support from Marie Curie Cancer Care and its partners in Lincolnshire, including Lincolnshire primary care trust and St Barnabas Hospice, John was able to move into Kenneth's home, where he wanted to spend his final months. The charity helped organise care for John around Kenneth's work commitments.

Kenneth said: 'If there is any such thing as a good death, I believe John had one. It was a very special experience for him to be able to stay at home with us until the end.'

Only four in 100 people would choose to die in hospital. Marie Curie Cancer Care is committed to making the choice to die at home a reality for everyone.

Peter Crutchfield is director of service modernisation at Marie Curie Cancer Care.