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Palliative Care Needs Urgent Reform

Experts are urgently calling for major reforms to the UK’s system of palliative care, in response to a significant and continual increase in demand caused by the COVID-19 pandemic.  

Researchers at Cicely Saunders International, a leading charity supporting palliative care, have published ‘You Matter Because You Are You’- a seven-point Palliative Care Action Plan that identifies the major challenges now facing the palliative care system, and outlines evidence-based solutions for each of them. 

During 2020, demand for palliative care surged, reaching levels of need similar to those which had previously only been expected to be hit in 2040. The wide-ranging impact of the pandemic on NHS services – including delays to surgeries and consultations, an increase in long-term conditions and changes to how health and social care is delivered – is anticipated to result in a sustained increase in demand for palliative care, exceeding previous forecasts.  

The accelerated demand has highlighted and exacerbated existing shortcomings in the palliative care system, compromising patients’ care and affecting families and carers. The researchers say that urgent reforms are now vital to bring the palliative care system up to speed with new levels of demand.  

The researchers warn that patients currently do not have enough choice or control over decisions taken about their care. Too many people with life-limiting illnesses – as well as those approaching death – are spending long periods of time in hospital unnecessarily, without the option of an alternative care setting. Meanwhile, hospital admissions have been rising to unsustainable levels across the country – and risk overwhelming parts of the NHS during the COVID-19 pandemic. 

The experts said that a lack of coordination and information-sharing between health and social care providers is restricting patients’ choices and compromising the quality of their care. 

Professor Irene Higginson, Scientific Director, Cicely Saunders International, said: “The COVID-19 pandemic has made it clear that when the demand for health and social care services goes up, the provision of palliative care falls short. The demand on NHS services we saw during 2020 is unprecedented, but it is also an indication of the challenges we will face in the future.  We need to start preparing for those now, as we respond to and recover from the lasting impact of the pandemic. It’s vital that we learn from this experience and implement the changes necessary to secure high quality palliative care for all patients.” 

The Action Plan draws on research carried out by Cicely Saunders International during the pandemic, as well as evidence from Government-commissioned reviews and independent reports. It sets out 24 achievable actions, each designed to improve the care patients receive and increase the efficiency of NHS services, ensuring the palliative care system can cope with the accelerated demand. 

The Action Plan advocates a holistic approach to improving the provision of palliative care, identifying challenges and solutions across the health and social care system. It recommends reforms to the care delivered in hospitals, hospices, care homes, patients’ homes and in the community, as well as calling for an overhaul of the education and training for health and social care professionals, and greater investment in research. 

A primary focus of the Action Plan is to increase and facilitate the provision of palliative care in all healthcare settings, in order to improve patients’ experience and alleviate pressures caused by unnecessary hospital admissions.  

Dr Ros Taylor MBE, Palliative Physician, said: “We have witnessed an avalanche of suffering in the last year, compounded by isolation and grief. We have a new awareness of our mortality. The need for palliative confidence and expertise in all settings, the sharing of skills across boundaries, the dissolving of bloated bureaucracy and an understanding of community compassion has been starkly unveiled during the COVID-19 pandemic and I urgently welcome the solutions captured in this timely, succinct and relevant Seven-Point Plan.”


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