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COVID-19: End-of-life care ‘not seen as essential’ during pandemic

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There has been a large increase in deaths There has been a large increase in deaths at home

Palliative and end of life care was compromised because services were not seen as 'frontline NHS' during the pandemic, a report from Marie Curie has claimed.

The report states that this caused shortages of personal protective equipment, and essential medicines. In 2020, the number of people who died was just over 695,000 – an increase of 91,000 on the previous five-year average (604,000). There has also been a large increase in deaths at home - the overwhelming majority of which were from causes other than COVID-19.

‘There has been a significant increase in the number of people dying at home during the pandemic,’ said Carolyn Doyle, Professional Lead for Community and End of Life Care at the Royal College of Nursing.

‘This has put increased pressure on nursing staff working in the community, they have found themselves frustrated that they have not always been able to provide the level of care that patients and their families deserve and our community nursing teams deliver so compassionately. Whether it is through increased demand, staff shielding or needing time off sick, services have been adversely overstretched.

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Primary care services also delivered more palliative and end of life care, with GPs and district nurses increasing their support for people dying at home. However, community and home-based care was particularly stretched, meaning people may not have been able to access the support they needed.

At the same time, slogans such as 'stay at home, protect the NHS' may have discouraged people with life-limiting illnesses to seek hospital care when they needed it. The researchers highlight that societal preferences and expectations for death and dying may have permanently changed, and if so, that new models of delivering palliative and end of life care in the community would be needed to reduce pressures on the NHS and ensure dying people are supported to die well at home.

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‘General Practitioners, Community Nurses and Care Home staff have all been at the front line of end of life care during the pandemic,’ said Dr Stephen Barclay, a GP and Consultant in Palliative Care from the Department of Public Health and Primary Care at the University of Cambridge.

‘There is a pressing need for their central role in caring for people at the end of their lives to be recognised, supported and adequately resourced.’

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