End of life care across England is not being prioritised

King’s College London has reported that local authorities have failed to prioritise palliative and end of life care, despite the health care challenges posed by a rapidly ageing population.

Published in the journal Palliative Medicine, the research finds that only four per cent of the Health and Wellbeing Strategies from 150 local authorities cite end of life care as a priority. Palliative care aims to achieve the best possible quality of life for patients and their families, but, as the UK faces having an ageing population, the need for better palliative care becomes greater. Research suggests that the demand for palliative care will increase by 42 per cent by 2040.

Researchers found that of the 150 strategies identified, end of life care was mentioned in just over half 78 (52 per cent) and prioritised in only six (four per cent). In 43 of the 78 strategies, end of life care was mentioned in connection with specific medical conditions, with ageing and dementia the most cited.

The King’s College team also found that, with budgets for specialist palliative care services ranging from £51.83 to £2,329 per patient per annum across England, being able to provide robust evidence about the effectiveness of treatments could have a bearing both on provision and budgets.  

Dr Katherine Sleeman, from King’s College London’s Cicely Saunders Institute for Palliative Care, Policy & Rehabilitation, said: “This is the first study to systematically analyse content relating to end of life care within local health care strategies and provides a comprehensive national picture of priorities and plans. What we found is that while half of Health and Wellbeing Strategies mention end of life care, few prioritise it, and none cite evidence for effective interventions This is concerning, especially as end of life care has been highlighted as a priority for policy makers nationally and internationally.

“This research highlights the large variations in the prioritisation of palliative and end of life care across England and underscores the need for greater scrutiny of local health and care strategies to avoid the unintended creation of a palliative care post code lottery.”