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24/7 palliative care nursing still patchy

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Round the clock community nursing support for end of life care patients remains available in only half of primary care trusts in England, a charity has claimed.

The national end of life care strategy, published in 2008, called on PCTs to make access to community nursing available at all times to patients requiring palliative care.

However, a Freedom of Information Act request by cancer support charity Macmillan found only 56 per cent of the 127 PCTs that responded were providing 24/7 community nursing to all patients at the end of their life in January.

This suggests little improvement since the strategy was introduced. A National Audit Office report in 2006-07 said 24/7 community nursing was available to all patients in their home in around 53 per cent of PCTs.

The Macmillan report was published on the same day that the government announced an independent review into palliative care, which will primarily focus on funding but will also look at ways to encourage more community based care to enable people to die in their own homes.

The review, announced last week by Andrew Lansley in his first major speech on social care since becoming health secretary, is intended to lead to a fairer funding system for all hospices and palliative services.

Macmillan Cancer Support chief executive Ciaran Devane said: “We welcome this review into end of life care but it must fill the gaps in service provision to make 24/7 care a reality.”

Jonathan Ellis, director of policy at charity Help the Hospices, told Nursing Times a replacement funding system was urgently required for palliative care.

He said: “One of the challenges we see is immense variation in the level of support hospices get from PCTs and the NHS. There are still some hospices that get little or nothing from the NHS and we are looking for the review to address that.”

Mr Ellis also said that in many areas PCTs had failed to pass on the quarter of a billion pounds provided alongside the national end of life care strategy to frontline palliative care services and the situation must not be repeated.

The independent review, which is being chaired by Marie Curie Cancer Care chief executive Tom Hughes-Hallett, will cover adults and children’s services and will report back by summer 2011.

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Readers' comments (2)

  • It's a shame, the End-of-Life Care Strategy has so many proposals to make it possible for people to die at home, where a majority, though not all, would prefer to be. In the area where I work there has been no increase in resources to make it happen, just extra expectations on the staff already there. I feel strongly that all end of life care should be the remit of the NHS, yet we still rely on charitable institutions to provide community and in-patient palliative care. In the current economic climate this is unlikely to change.

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  • I agree with you Chris, I wonder if the right question was asked when 127 PCT's responded by saying they provided 24/7 care. Was it patients needs or PCT provision only that patients and there relatives recieved? Did the PCT's have any idea what the actual process was for end of life care. And of course was it the right care at the right time or were families given a number to phone which is manned by a team who were already out doing the job and not contactable for an immeadiate response. Not exactly Gold Standard. Providing end of life care is stressfull enough without having to run the gauntlet of paperwork and poor staffing levels

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