PlayFailures over 'end of life' care
Published: Wednesday, 26 November 2008, 12:11PM
Many terminally ill patients who want to die at home are being needlessly admitted to hospital, a report has said.
According to the National Audit Office (NAO), the majority of National Health Service doctors and nurses lack training in end-of-life care and many people die in hospital when there is no clinical reason for them to be there.
As many as 74 per cent of people would like to spend their final moments at home but the NAO's End of Life Care report said 58 per cent of deaths take place in hospital.
Karen Taylor, director of health studies at the NAO, said "generally services are not meeting people's needs" and described co-ordination as "poor".
An estimated £104 million could be saved if emergency admissions were cut by a tenth and the average length of hospital stay was reduced by three days where people had no medical need to remain there, the report said.
As part of its research the NAO asked Primary Care Trusts (PCTs) how much they spent on palliative care and found estimates varied from £154 and £1,684 per person. The average for the 151 PCTs which responded was £504.
Tim Burr, head of the NAO, said: "Good end of life care should mean that people are treated with dignity and respect and, where possible, in their preferred place of care. Some people receive high standards of care in their final weeks, days and hours, but others do not."
He said organisations need to improve the planning and delivery of services, particularly support in the community, by using resources more efficiently and effectively.
The report follows the July publication of the Government's End of Life Care Strategy which pledged to raise the profile of care for those nearing death.
It will be debated by the Committee of Public Accounts whose chairman, Conservative MP Edward Leigh, said: "Dying people are often not being treated with the dignity and respect they deserve and their wishes are often disregarded. Most people want to die at home. Most die in hospital."
He added that the resources being used for unnecessary hospital care should be diverted to support people "where they choose".
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