Survey reveals how NHS pressures put further strain on end of life care

A survey conducted by Marie Curie  and the Nursing Standard demonstrates how pressures on the NHS are compromising care for terminally ill  patients. 


It found that 94% of nurses who participated in the survey (n over 600) have witnessed dying patients ‘stranded’ in hospital as delays in funding have meant they were unable to receive care in the community.

Among the survey’s key findings were:

  • Almost two-thirds (65%) of nurses say they do not have sufficient time to provide high quality care for patients who are dying, a similar proportion to those who answered the survey last year.
  • Staffing levels (38%) and time constraints (25%) were the main barriers identified to providing high quality care, followed by a lack of care provision in the community, including care homes, peoples’ homes and hospices.

The full press release is available on the Marie Curie website 

The full results of the survey are published in latest issue of the Nursing Standard which is available to Rotherham NHS Staff here 


Is earlier access to palliative care associated with better quality end of life care?

New research published in the BMJ outlines the benefits of early access to palliative care for terminally ill patients. The cohort study which examined the experiences of cancer patients in Yorkshire found that patients who were able to access palliative care earlier, experienced improved quality of life.

hospice-1793998_1920The study led by Lucy Ziegler, University of Leeds and Yorkshire Cancer Research questioned if there is an optimal point when a patient should begin to receive palliative care,  when the focus switches from trying to treat disease to managing symptoms.

While research in the US suggests that should happen about six months before death. But in the UK, most advanced cancer patients only start palliative care seven weeks before they die.

Full story available from The University of Leeds  The benefits of early access to palliative care 

The full abstract can be read in the BMJ  

The full text article can be downloaded here 

Related story: The Independent Too few cancer patients are getting end of life care 

End of life care collaborative

NHS Improvement have published information about the End of life care collaborative.  They ran a 150-day programme, involving 16 volunteer trusts, to improve end of life care across a number of settings to improve the experience and quality of care received by patients at end of life.  They have published the following case studies:

Chesterfield Royal Hospital NHS FT
Sheffield Teaching Hospitals NHS FT
Rotherham NHS FT
Hillingdon Hospitals NHS FT
St George’s University NHS Trust
Cumbria Partnership NHS FT
Colchester Hospital University NHS FT


Award-winning initiative gives people the opportunity to shape their end of life care

Warrington CCG has landed a top prize in the Health Service Journal Awards for their work to improve end of life care with personal health budgets.

Winning the 2017 “Compassionate patient care” award, Warrington is one of five areas across the country now giving people more of a say in the care they receive in their last weeks and months of life. Personal health budgets are part of a range of work being led by NHS England to improve end of life care.

Hear patients, hospice staff and commissioners talk about the benefits of personal health budgets in Warrington in this short film:

Study shows dying at home more comfortable than hospital

Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study | BMC Geriatrics | published online 5th  October 2017

A study from the University of Cambridge in the UK found that elderly people were four times more likely to die comfortably if their last days were spent at home or in a “care home”—defined to be either a residential care home or a nursing home—than if they were in a hospital.

Jane Fleming, a senior research associate at Cambridge, and colleagues, reported in BMC Geriatrics about their retrospective analysis of data from 180 deceased participants, ages 79-107 years. Relatives and caregivers were asked about the patients’ comfort level. The researchers learned only 10% of all participants died without pain or symptoms of distress.

Full document available at BMC Geriatrics


End of life care for homeless people

The Care Quality Commission and Faculty for Homeless and Inclusion Health have published A second class ending: exploring the barriers and championing outstanding end of life care for people who are homeless.

This report draws on research findings which explored the challenges to palliative care for homeless people in London.  It explores homeless peoples’ views and experiences of palliative care and aims to understand how they believe support could be improved.  It includes a series of case studies and recommendations.

second class
Image source:

Key discussion points

  • The needs of homeless people are not well understood or considered by health and care services. Where services do exist, they are often fragmented and work in relative isolation.
  • These issues are exacerbated by a lack of training and support for frontline staff.
  • Identifying homeless people who may be dying is difficult. Involving homeless people in decisions about their treatment and care means striking the right balance between supporting them and respecting their individual choices.
  • Actively linking health care, social care, housing and voluntary services may improve the care options available.
  • Working together will help continuity of care – this needs a collaborative effort across services.
  • There must be a strategic, equality-led approach at a local level, delivering personalised care. We share examples of excellent primary care and specialist community services.
  • Hospices and primary care organisations in particular can play a key role in championing an equality-led approach.

Additional link: CQC press release

The role of care homes in end of life care

The role of care homes in end of life care | National End of Life Care Intelligence Network |  Public Health England

care home
Image source: Brian Bullock – Flickr // CC BY 2.0

Public Health England’s National End of Life Care Intelligence Network has published two new data briefings, an infographic and a section of indicators on the End of Life Care profiles:

This briefing  presents data that describes the availability of residential and nursing home places together with the older population and the number of deaths.

This second briefing describes the recent trends in the demographics of people who receive end of life care in a care home.

An infographic summarising the key points from the two briefings can also be downloaded here

A new domain has been added to the end of Life Care profiles. These profiles can be used to explore local trends in this data, make comparisons with neighbours or regions and download maps and area profiles.