National Survey of Bereaved People (VOICES): England, 2015

ONS Statistical Bulletin

Main points:

  • 3 out of 4 bereaved people (75%) rate the overall quality of end of life care for their relative as outstanding, excellent or good; 1 out of 10 (10%) rated care as poor.
  • Overall quality of care for females was rated significantly higher than males with 44% of respondents rating the care as outstanding or excellent compared with 39% for males.
  • 7 out of 10 people (69%) rated hospital care as outstanding, excellent or good which is significantly lower compared with care homes (82%), hospice care (79%) or care at home (79%).
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Image source: ONS

  • Ratings of fair or poor quality of care are significantly higher for those living in the most deprived areas (29%) compared with the least deprived areas (22%).
  • 1 out of 3 (33%) reported that the hospital services did not work well together with GP and other services outside the hospital.
  • 3 out of 4 bereaved people (75%) agreed that the patient’s nutritional needs were met in the last 2 days of life, 1 out of 8 (13%) disagreed that the patient had support to eat or receive nutrition.
  • More than 3 out of 4 bereaved people (78%) agreed that the patient had support to drink or receive fluid in the last 2 days of life, almost 1 out of 8 (12%) disagreed that the patient had support to drink or receive fluid.
  • More than 5 out of 6 bereaved people (86%) understood the information provided by health care professionals, but 1 out of 6 (16%) said they did not have time to ask questions to health care professionals.
  • Almost 3 out of 4 (74%) respondents felt hospital was the right place for the patient to die, despite only 3% of all respondents stating patients wanted to die in hospital.

Read the full report here

IMPROVING PALLIATIVE CARE DATA COLLECTION

Public Health England’s National End of Life Care Intelligence Network (PHE NEoLCIN) has published a statement updating progress towards a new national data collection from specialist palliative care services.  The new data collection is due to start in July 2016 from NHS and non-NHS hospital, hospice and community specialist palliative care services, with full implementation scheduled for April 2017. It is being supported by the development of a new national information standard.

Additional link: PHE press release

Estimating the cost of caring for people with cancer at the end of life: A modelling study

Background: People with advanced cancer require a range of health, social and informal care during the final phases of life. The cost of providing care to this group as they approach the end of their lives is unknown, but represents a significant cost to health and social care systems, charities patients and their families.

Aim: In this study, we estimate the direct and indirect costs for lung, breast, colorectal and prostate cancer patients at the end of life (from the start of strong opioids to death) in England and Wales.

Methods: We use a modelling-based approach to estimate the costs of care. Data are estimated from the literature and publicly available data sets. Probabilistic sensitivity analysis is used to reflect uncertainty in model estimates.

Results: Total estimated costs for treating people with these four cancers at the end of life are £641million. Breast and prostate cancer patients have the highest expected cost per person at £12,663 (95% credible interval (CI): £1249–£38,712) and £14,859 (95% CI: £1391–£46,424), respectively. Lung cancer has the highest expected total cost (£226m). The value of informal care giving accounts for approximately one-third of all costs.

Conclusion: The cost to society of providing care to people at the end of their lives is significant. Much of this cost is borne by informal care givers. The cost to formal care services of replacing this care with paid care giving would be significant and demand for care will increase as the demographic profile of the population ages.

Reference: Round, J, Jones, L and Morris,S.  Estimating the cost of caring for people with cancer at the end of life: A modelling study.  Palliative Medicine. Published online before print July 21 2015.

National Survey of Bereaved People (VOICES)

The National Survey of Bereaved People (VOICES, Views of Informal Carers – Evaluation of Services) collects information on bereaved peoples’ views on the quality of care provided to a friend or relative in the last 3 months of life, for England.

This statistical bulletin reports on the national results from the 2014 VOICES survey. This report includes findings from new survey questions, such as adequate provision of food and fluid in the last 2 days of life and quality of communication with carers.