Certain patient groups experience lower quality end of their life care than others because providers and commissioners do not always understand their specific needs, a report by the CQC has found.
The report, A different ending: Addressing inequalities in end of life care, identified cases where people did not receive the best care possible, due to a lack of consideration about their beliefs and culture. According to the report, patients from groups such as the homeless, those with mental health conditions or learning disabilities, and black and minority ethnic, have specific needs at the end of life, which were not always taken into account by care providers.
‘A person’s diagnosis, age, ethnic background or social circumstances should not affect the quality of care they receive at any point, but certainly not at the end of their lives,’ said Steve Field, chief inspector of general practice at the CQC. ‘What is important is that everyone receives care based on their individual needs, delivered with compassion and sensitivity by staff with the right skills, and that there is regular and effective communication between staff and the dying person and their family.’
The report made a number of recommendations to improve palliative care for all patient groups. For staff in general practice, it recommends that everyone with a life-limiting condition should have ongoing conversations about end-of-life care, and is given a named care coordinator. It also states that staff providing palliative care in settings such as community should be provided with training on cultural awareness, and care for people who have dementia.
‘Many people should now be having the kind of death they want in a place of their choice and with well-managed symptoms and minimal pain. If this can be achieved it can be a great comfort to the person themselves and to their loved ones,’ said Amanda Cheesley, professional lead for long term conditions and end of life care at the RCN. ‘Death can come at any hour of the day or night and expert care needs to be available at all times to all who need it but under-resourced community and district nursing teams can make that care very difficult to provide.’