NHS hospitals ill-equipped for end-of-life care

A major investigation into end-of-life care has revealed a worrying lack of training among NHS staff in the support and treatment of dying patients and their families. According to the Royal College of Physicians there was a ‘significant variation’ in the standard of care provided.

Many hospitals were shown to perform well, however it was found that only a quarter of NHS trusts had mandatory training in the care of dying patients in place of doctors and nurses. Three quarters of hospitals had no palliative care at all during weekends.

Major communication problems were also reported between care staff and patients, with over half of cases seeing staff members failing to tell patients when they were entering their final days of life. Friends and family were typically informed of their loved ones entering their final days 31 hours before death, but a quarter felt they had not been involved in decisions made regarding care.

The findings came from an audit of case notes of over 6,500 patients who passed away in 149 hospitals in England last May, as well as a questionnaire of almost 1,000 bereaved relatives/friends and information provided by NHS trusts on training and availability of end-of-life care within their organisation.

Professor John Ellershaw, director of the Marie Curie Palliative Care Institute (which collaborated with the RCP on the study) said,

“Too many patients are dying badly in our hospitals when we know how to care for them well. If some hospitals can provide good outcomes in care then all hospitals can.”

In response to the study, care minister Norman Lamb commented to say that all patients should be receiving compassionate and high quality care during their last days of life and that there can be no excuse for anything less. He also said to help address the issues raised by the investigation, the government will be working on plans to support all services in giving everyone in their last days of life (and their families) the high quality care they deserve.