Government urged to ‘radically’ overhaul end of life care

The most vulnerable people are being failed by poor end of life care due to lack of staff training, a group of health and social care organizations has said.

In an open letter to the government, the Coalition of Frontline Care for People Nearing the End of Life has called for “radical transformation” in the care given to older people approaching end of life, such as improving staff training to help patients “live well and die at home”.

The groups, including Care England and the National Care Forum, sent the letter to the health and social care secretary Steve Barclay and social care minister Helen Whately last week.

“If the government is willing to grasp the nettle on this issue, we can bring about a step-change in care”

Martin Green

hey said the case for change was strong because the current system “is not working” and will only worsen as the population continues to age.

As such, they have called for enhanced core training in end-of-life care for the UK’s generalist frontline health and social care workers.

In addition, they said they also wanted to see a change in health and care integration from the new integrated care boards (ICBs) and heightened recognition of end-of-life care by the regulator CQC.

It comes as around a third of the NHS budget is currently spent caring for people in the last year of their lives.

The coalition argued that as most care for older people in their last year of life is given by the frontline workforce, they should be “well trained in proactive, personalised end of life care”.

The letter said: “We need both enabled, well trained, up-skilled generalists and support from specialists working together.

“It is, therefore, essential that we invest in training and support for the generalist workforce, most notably those in social care who are often omitted from NHS plans.”

The calls also come as the number of people aged over 85 is set to double in the next 20 years, while the number of UK deaths in projected to rise by 25%.

The groups said that “repeated surveys” showed that most people would prefer to die at home or in a care home, yet almost half die in hospital with repeated emergency admissions in their final year.

The letter said: “Too often we hear of older people enduring poor quality care and the distress of families navigating a system not fit for purpose.

“We believe things could be different and that we must strive to ensure quality care at the end of life for all,” it stated.

Professor Martin Green, chief executive of Care England, said: “Implementing a policy of enhanced core training in end-of-life care for all frontline generalist staff in health and social care is essential if we want to reduce suffering for older people in their final years. “

“In each individual case there is only one opportunity to get end of life care right,” he said. “If the government is willing to grasp the nettle on this issue, we can bring about a step-change in care.”

Department of Health and Social Care spokesperson said: “ICBs are responsible for commissioning palliative and end of life care to meet local needs, and NHS England provided £1.5bn additional funding to ICBs to provide support for inflation last year.”

“Our £570m The Market Sustainability and Improvement Fund (MSIF) Workforce Fund will increase adult social care capacity, improve market sustainability, and enable local authorities to make tangible improvements to adult social care service such as end-of-life care.

“We also invested £8m last financial year to provide training to support community health service staff retention and training to improve quality of care,” they said.