Government will unveil plans to improve access to end-of-life care across the country amid concerns around a postcode lottery of access to care
Patients with terminal illnesses will have more choice over where they die, better access to care at home and fewer trips to A&E under an overhaul of the palliative care system.
The Government will next week unveil plans to improve access to end-of-life care across the country.
MPs voted in favour of legalising assisted dying in some circumstances earlier this year but the heated debate over the issue has raised questions around the quality of palliative care on offer for people who are receiving end-of-life care.
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Concerns were, in particular, raised around the lack of consistency and access to good quality care – with people often faced with a postcode lottery when it comes to services they can access.
On Tuesday, care minister Stephen Kinnock will address the Hospice UK conference where he will announce the launch of a new regulatory framework aimed at tackling the issue.
Details of the plans, seen by The i Paper – which will be underwritten by the so-called modern service framework (MSF) – include measures to address staffing shortages, patients being unnecessarily admitted to hospital against their wishes and access to support varying across the country.
Ending the variation in the local and regional provision of care – in terms of both access and quality – will be central to the changes, Kinnock will say.
Integrated care boards – the local NHS bodies responsible for planning and funding local health services – will have to ensure end-of-life and palliative care is of a higher and more consistent quality.
This may include identifying palliative care patients earlier and offering care closer to home and with better out-of-hours services.
Patients will also have more say over the shape of their neighbourhood-run care plans – part of the Government’s 10-year strategy for the NHS to shift care from hospital to community.
Community teams made up of hospice staff and palliative care experts will be required to work more closely with care homes and paramedics to avoid people being taken to A&E by default, where they may receive medical treatments they do not want.
And advice and support will be focused around helping more people die in their home, where appropriate. At the same time, rapid response teams will be on hand to help with symptom management, including pain.
Kinnock said the Government is open to engaging with the care sector to shape how the regulations would work, but added that ministers are “resolute in our commitment to palliative and end-of-life care being at the heart of the shift from hospital to community”.
He told The i Paper: “We want to deliver better integrated care, more community health support, and identify patients who are approaching end of life earlier. This is the first step toward delivering essential reforms so everyone can receive high quality care when they need it the most.”
Full details of the plan will be published in the spring.
It comes after the Government announced £100m of capital funding for the sector to help hospices improve their care environments, following a sustained campaign from industry voices.
Another £80m was set aside to support children’s hospices over three years.
But the sector has been issuing warnings over the longer-term funding plan, with Hospice UK revealing last month that more than 60 per cent of hospices ended 2014 in financial deficit.
Toby Porter, CEO of Hospice UK previously said two-fifths of hospices are planning to make cuts this year, warning the current funding programme is untenable.
The organisation is pushing the Government to implement a full funding plan for palliative care, including introducing proper NHS contracts for hospices and covering the increase in staffing costs – partly brought on by the rise in National Insurance Contributions.
Responding to the announcement this week, Porter praised what he said was a “firm and clear commitment” from ministers to “making certain everyone gets the care they need, where they need it, when they die”.
“We must now move quickly. The framework must deliver fair funding for hospice services this year. With better funding and commissioning, hospices can deliver the community-based services the Government is rightly aiming to expand, taking the pressure off hospitals,” he said.
“This change can’t come soon enough; hospice services are being cut. We look forward to working with government, at pace, to protect vital hospice services and to deliver a framework that brings real change to a broken system.”
Ministers said neighbourhood-based care will be boosted through the expansion of the uptake of Personal Health Budgets (PHBs).
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Such budgets help patients manage how their health and care needs are met and 180,000 people have one today.
But the number offered will be doubled by 2028/29, increased further to one million by 2030 and be universal by 2035.
The Department for Health and Social Care said this expansion would make palliative care and end-of-life care more easily accessible for people and their families and help “people die in the place of their choosing”.