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UK's palliative care ranked top in international list

  • 11 Comments

The UK has been ranked top in a list which compares palliative care across 80 countries, including Australia, the US and Sweden.

It came first in three out of the five categories used to produce the overall rating – the palliative and healthcare environment, affordability of care, and quality of care.

In the human resources category the UK came second after Australia, and it was placed joint third with France for community engagement after New Zealand and Belgium.

“The UK is an acknowledged leader in palliative care. But there is more that the UK could do to stay at the forefront of palliative care standards”

Annie Pannelay

The UK was highlighted for the attention paid to palliative care in both public and non-profit sectors, its “strong” hospice movement and a national strategy to integrate palliative services into the NHS.

Despite the UK’s high ranking position in the 2015 Quality of Death Index, the Economist Intelligence Unit – which produced the list following research and interviews with over 120 experts – said there was still room for improvement.

Those behind the report referred to a recent investigation by the Parliamentary and Health Service Ombudsman into complaints about end of life care which highlighted issues including poor symptom control, inadequate communication, and delays in diagnosis and referrals for treatment.

The EIU also warned of increasing demand in the UK in the future due to an ageing population and the growing prevalence of non-communicable diseases such as cancer, dementia and diabetes.

The report also measured future demand for palliative care. It found that that while the UK had a high need compared to other countries, its provision was good so there was less of a gap between the two.

Countries such as China, Greece and Hungary were “most worrying” because of the high demand for services but relatively poor provision.

“For wealthy nations with sophisticated healthcare services, the challenge is moving from a culture of curing illness to managing long-term conditions”

2015 Quality of Death Index

“For wealthy nations with sophisticated healthcare services, the challenge is moving from a culture of curing illness to managing long-term conditions,” said the report.

Annie Pannelay, principal of EIU healthcare, said: “The UK is an acknowledged leader in palliative care. That reflects its comprehensive strategy towards the issue, as well the improvements that are being made, for example in ensuring that people get to spend their final days in the place of their choice.”

“But there is more that the UK could do to stay at the forefront of palliative care standards, such as ironing out occasional problems with communication or symptom control. This issue will become increasingly important in an ageing population,” she added.

“We know from our own research that each year around 110,000 people are missing out on [palliative] care that they urgently need”

Simon Jones

In response to the report, Marie Curie’s director of policy and public affairs Simon Jones warned the UK’s top position in the list should not detract from the many improvements still required.

“While we recognise the great work that makes the UK a world leader in palliative care, we know from our own research that each year around 110,000 people are missing out on care that they urgently need,” he said.

Dr Ros Taylor, national director for hospice care at Hospice UK, echoed his concerns and called for improved and increased training for hospital nurses and doctors to tackle the sometimes “appalling neglect” in this setting.

“In addition to tackling substandard palliative care in hospitals and other settings, there needs to be concerted action to reduce the high numbers of dying people in hospital, who would be much better supported in other settings, including hospices or their own homes,” she added.

  • 11 Comments

Readers' comments (11)

  • michael stone

    I've been listening to the comments to this report today [and it examines, I understand, things such as 'policy' to a large extent].

    Simon Chapman was on BBC Radio 4 at lunchtime, and he said there is a variation on the one where a football manager, responding to 'Why are you so successful ?', said 'In all honesty, the opposition isn't up to much'.

    So although the UK is a world-leader in end-of-life care, to an extent that is more a reflection of how poorly a lot of other countries are doing, rather than a statement that we are doing it really well, most of the time.

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  • That report just means that the rest are worse,it praises us for being aware and hving stratergies etc.That does not mean we are good at it..we are not.

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  • michael stone

    Anonymous | 6-Oct-2015 5:49 pm

    I don't think the evidence is that the UK is bad for end-of-life - more that the care and behaviour varies enormously from 'it could not have been any better' through 'reasonable' all of the way to 'pretty dreadful'.

    The Liverpool Care Pathway was an attempt to improve the EoL care provided by non-specialists, and it failed to achieve that in too many cases. The new 'approach' is to try and use more 'principles' and less 'tick-box' but of course that requires even better 'understanding of' end-of-life than the LCP did, and the reason the LCP failed is usually given as 'inadequate training' (unless 'inadequate resourcing' is argued).

    It is that I had picked up on 'it praises us for being aware and having strategies' which is why I will not be bothering to read this particular report.

    We are also fairly hopeless with immediately post-mortem behaviour for EoL Home Death, as I've analysed:

    http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=785&forumID=45

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  • I have observed systemic neglect and abuse here seemingly instigated by PCT/CCG and practised by nursing home provider in lieu of lawful, palliative care.

    I whistleblew, still suffering the ramifications of that, and still the CQC has failed to withdraw nursing registration from the home.

    A trip to Specsaver might be the prescribed treatment for Annie.

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  • michael stone | 7-Oct-2015 11:24 a

    stony, do go and find yourself a comic to comment in.

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  • michael stone | 7-Oct-2015 11:24 am

    so now you consider professional healthcare teams as non-specialists. you fail to achieve comprehension in anything you chose to waffle about here. go away!

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  • michael stone

    Anonymous | 7-Oct-2015 2:22 pm
    Anonymous | 7-Oct-2015 2:24 pm

    I wondered where you had got to.

    Re

    'so now you consider professional healthcare teams as non-specialists'

    for legal issues, yes [they are usually not 'very expert']: for clinical issues, I do consider them to be specialists.

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  • Rubbish stone we are certainly more expert than some of the legal profession. Who do you think ended up teaching who on my university medical
    Law and ethics course. Our lecturer had no clue of end of life care in hospitals, just like you!band what do you suppose these courses are for if you think we know nothing fool?

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  • michael stone

    Anonymous | 8-Oct-2015 7:14 pm

    I don't know who taught your law and ethics course - but from my discussions, I am of the opinion that most medics are better at the 'ethics' bit than at the 'law' bit [and that seems to be true for medical academics as well] but your implication seems to be that a lawyer taught the course.

    As it happens, a piece about end-of-life has just appeared on the BMJ website: I've commented on it, perhaps you would care to, the article is at:

    http://www.bmj.com/content/351/bmj.h4855

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  • As I said, as a multidisciplinary group of healthcare workers, we ended up teaching the lawyer about end of life care in hospital practice and not the other way round!

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