Hospitals failing to provide adequate palliative care, review finds

A national review of end-of-life care by the Royal College Physicians found that most hospitals are failing to provide face-to-face palliative care specialists around the clock.

While it maintains that some improvement has been made, there were still a number of concerns.

The study is the first review of the system since the controversial Liverpool Care Pathway was scrapped. The Pathway has been replaced by a series of guidelines which suggests moving away from a one-size-fits-all approach.

It cited that only 16 of 42 hospital sites in England offered specialist on site 24/7 care.

The researchers examined 9,000 patients notes and found there was no written evidence to suggest that do not resuscitate (DNR) decisions had been discussed with relatives or friends. It also warned that many patients and doctors did not have enough access to on-site palliative care specialists at evenings and weekends.

Study-lead Dr Sam Ahmedzai said: "We know that most front-line doctors and nurses giving end-of-life care do it to a very good standard. But the problem happens when things start to go wrong and often they go wrong out-of-hours in the middle of the night and at weekends.

"Then doctors and nurses who may be inexperienced need to be able to access specialists in palliative care."

NHS England, which commissioned the review, welcomed the improvements, but said it was clear that more could be done.

A spokesperson for NHS England said: "Although this audit presents a snapshot of end-of-life care within NHS hospitals, there are clear variations in the support and services received - and there are areas where improvements must continue to be made."