Assisted dying debate showed why palliative care must be improved - Victoria Wharton
Whilst the Terminally Ill Adults (End of Life) Bill was voted down in the House of Commons this month, the need for more urgent and ambitious action to fix end of life care could not be clearer.
Marie Curie has remained neutral in debates on assisted dying – neither campaigning for or against a change in the law. But it is welcome that throughout the hours of parliamentary debates, a significant consensus emerged that palliative care must be improved regardless of whether the law changed on assisted dying or not.
I fiercely agree. But we can no longer ignore the devastating fact that almost one in three people die without receiving the care and support they need at the end of life. We need decisive action.
The new Prime Minister has rightly acknowledged that palliative care is in crisis, but has yet to set out how his government intends to close the huge gaps in end-of-life care. In England, there are real opportunities on the horizon. The Modern Service Framework for palliative and End of Life Care, due to be published by the UK Government this autumn, has real potential to drive change.
Marie Curie wants to see the framework published soon and we’re calling for an initial short-term investment to support its delivery. By improving access to palliative care in the community, this would help to drive a shift away from expensive crisis-driven hospital care.
NHS data shows that in England 14 per cent of all emergency admissions to hospital, and 30 per cent of all bed days spent in hospital, involve people in the last year of life. The current lack of adequate access to palliative care in the community means that dying people and their carers often have no alternative but to attend A&E, call out an ambulance or be admitted to hospital at crisis point when they need help. That is not delivering care where many patients want to be, and it is extremely costly for our NHS.
I know there is a solution. Take our Responsive Emergency Assessment and Community Team, known as REACT, in Bradford. In partnership with the Bradford Royal Infirmary, this service sees Marie Curie specialist teams working in the emergency department and the local community to identify people at the end of life earlier. Instead of hospital admission, patients, where appropriate, are admitted to the care of REACT where they can access community or hospice-at-home services.
We also have teams in Yorkshire and across the country working with local GP practices and in care homes to ensure patients at the end of life receive early intervention. Our aim is to make sure people can plan their end of life, and they receive the high-quality care and support they deserve at their most vulnerable time. I only wish that everyone could have access to this kind of care, because a good death should not be a postcode lottery.
The Government has rightly set out ambitions to fix end of life and palliative care, but this is not simply about spending more money on the existing system. It's about transforming how care is delivered so that people can access the right support, at the right time, wherever they live.
We need a clear and ambitious national plan to tackle longstanding inequalities in access and greater investment in community-based care. We need people approaching the end of life to be identified earlier so support can be put in place before a crisis occurs. Dying people and their families have waited long enough; they need compassion, dignity, and support, not more delays.
Victoria Wharton is director of Caring Services, North of England at Marie Curie.