National review says end of life care not good enough

Researchers have found that end of life care in NHS hospital is failing patients, with many not receiving face-to-face palliative care from specialists in their final hours of life. The announcement follows our previous blog (End of Life Care), which explores what End of Life Care means in reality.

Only 16 of 142 hospitals in England have palliative care specialists on site 24 hours a day. This means that patients requiring palliative medicine outside of the 9am-5pm working day are not receiving specialist care, but rely on nurses or non specialist doctors to provide treatment outside of their expertise. However these patients may be considered lucky, as the research has also revealed that do-not-resuscitate decisions are not always being discussed and some patients are not reviewed at all to see whether or not they are able to eat or drink during their final day of life.

Dr Sam Ahmedzai, the leader of the study, has said

We know that most front-line doctors and nurses giving end-of-life care do it to a very good standard. But the problem happens when things start to go wrong and often they go wrong out-of-hours…”.

Leading palliative care charity, Marie Curie, was involved in the funding of the research, and a spokesman for the charity has said

care of the dying has no respect for time, so if we are to deliver a consistent 7-day service by 2020, it is critical that funding is directed towards recruiting and training doctors and nurses to provide specialist care now”.

Remarkably, the research is published just six months after the UK was praised for its palliative care by independent researches (The Power House of Palliative Care). But a good deal of that success was attributed to charitable and other organisations outside the NHS, and pointed to a change in focus of the NHS towards investment in A&E services, rather than less acute services such as palliative medicine.

Clarke Willmott’s Clinical Negligence and Elderly Care & Court of Protection teams have recently hosted an “End of Life Care” conference, in conjunction with the Centre for Ethics in Medicine, with field leaders and those working with patients at the end of life contributing to the dialogue about what needs to be done to better care for the dying.

If you or an elderly relative need advice regarding access to health or social care provision then contact a member of our Elderly Care Team.

If you are concerned about the quality of medical treatment given to yourself or a relative, contact a member of our Medical Negligence Team on 0800 316 8892.