In 2005 my Auntie Helen, aged 66, was diagnosed with Mantle cell lymphoma. Chemotherapy was administered for more than nine years, and trial drugs for two years after the standard drugs became ineffective.
Two months ago, Helen was advised that her cancer had transformed into acute lymphoblastic leukaemia which was unresponsive to all forms of chemotherapy. On 4 June, the haematologist advised that she had as little as three weeks to live.
Helen called me immediately. She was determined that she would not die in hospital or die alone and we were delighted that she chose to move to our family home to be supported at the end of her life.
I called our GP practice manager and the process of transfer began. We brought Helen nearly 300 miles to our home and the following day the district nurse arrived to complete a skilled and comprehensive assessment of her needs.
Within two days Helen had seen a fabulous local haematologist and received blood and platelets as part of her palliative care plan. The equipment needed to support her increasingly challenged mobility was delivered the next day and she slept well in a modern hospital bed, complete with air mattress.
The district nurse referred Helen to a local hospice-at-home team (all district nurses) and a nurse visited to introduce themself on her fifth day with us.
One week after settling in, Helen suffered a haemorrhage which rendered her semi-conscious. The expert services that the district nurse had set up swung into action and Helen died later the same day, peacefully and comfortably as she had wished, with her family by her side.
We have brilliant nursing and allied health services in the NHS. I witnessed committed practitioners with the expertise to manage unpredictable, nuanced and complex care, with little control over the environment in which it is delivered.
If this seamless end of life care, delivered by practitioners working for a variety of employers with no integration, can be provided where I live - why not everywhere?