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End of life care is compromised as ‘crucial’ services are denied funds

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Primary care trusts spent just a quarter of the funds they were given to pay for end of life care on direct nursing provision to support patients dying at home.

The Department of Health’s second report into progress on the previous government’s 2008 end of life care strategy details what the £72m, which was given to PCTs to pay for the strategy, was spent on in 2009-10.

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The report shows £6m went towards rapid response 24 hour community services, £3m was paid to support Marie Curie or Macmillan nurses, and £8.6m was spent on specialist palliative care teams. In total around a quarter of the total pot was spent directly on services that provide nursing care to patients wanting to die at home.

Macmillan Cancer Support head of policy Mike Hobday said the fact only 8 per cent of the money went on 24 hour services was a major concern. Such services are seen as crucial for allowing patients to die at home, one of the main aims set out in the strategy.

Mr Hobday told Nursing Times access to community nursing out of working hours was “the essential step” needed to support patients nearing the end of their life to “spend their last days in the place of their choosing”.

He highlighted recent Macmillan research showing round the clock community nursing support for end of life care patients was available in only half of PCTs.

But Royal College of Nursing chief executive Peter Carter said in a statement patients would only receive “hospice standard” care at home “when round the clock district nursing teams are available everywhere”.

The government report also reveals a massive variation in spending on end of life care between PCTs. Two PCTs spent more than £4m on end of life care last year while eight spent nothing at all.

A second round of funding, worth £286m, was earmarked by the government in July for spending on end of life care in 2010-11.

Marie Curie Cancer Care director of research and innovation Steve Dewar said it was important there was “rigorous scrutiny” on how the second round of investment was spent. He said priorities should include reducing spending variations between PCTs and focusing on innovative practice that would allow more patients to die at home.

Earlier this month, Nursing Times exclusively revealed findings from the National End of Life Care Network, which showed the geographical and disease lottery that exists in the proportion of patients who are able to die in their own home.  

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