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Palliative care costs could be reduced by community nursing services

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Moving care into the communtiy could improve care Moving palliative care into the community could provide a more comfortable end of life

Shifting palliative care into the community could cut individual care costs by hundreds of pounds states a report by the End of Life Campaign.

A coalition of charities including Marie Curie and Macmillan Cancer Support, compiled the report On the Brink: The Future of End of Life Care based on the death data for the last 12 months published by the Office of National Statistics.

One of the key recommendations of the report is to shift care out of hospitals for more cost effective and personalised end of life care but warns that the right support needs to be in place at home and in other settings to enable this to happen. At the moment many people are being admitted to hospital purely because there is no adequate provision in the community. In the first weekend of December 2015, 12 hospital trusts were unable to admit any more patients after running out of beds, according to the report.

‘People at the end of life should be given choice over important issues such as where they spend their final days, and sadly we know that this isn’t always the case,’ said Lynda Thomas, chief executive of Macmillan Cancer Support. ‘Too often we hear of people being marooned in hospital, because they are not getting the right care at home. Nobody wants to see this happen as it is an appalling situation for the individual and puts strain on the health service.’

In its evaluation of the Marie Curie Nursing Services, the Nuffield Trust found that people who were cared for by a Marie Curie Nurse had total care costs of around £500 lower than those cared for in hospital. Just 8% of Marie Curie patients died in a hospital compared to 42% of people without a Marie Curie nurse. Only 12% of Marie Curie patients experienced an emergency admission to hospital compared to 35% of people without a Marie Curie Nurse. The charities believe that this can be replicated by other palliative care nursing services,

The report also found that 10% of people who died in the last year received care classified as poor. Some of the characteristics of poor end-of-life care identified by the report included a lack of access to social care for help with everyday tasks such as washing and changing clothes, and many families being left without professional advice on how to care for their dying relatives.

‘This is an astonishing and dismaying number of people being without the care and support they deserve in their final days,’ added Ms Thomas. ‘No relative or carer should be left feeling that their loved one has experienced poor care at such an important and precious time. It is unacceptable that lasting memories are being tainted by pain being poorly managed.'

The charities involved in collating the report included the National Council for Palliative Care, the Motor Neurone Disease Association, Sue Ryder and Marie Curie.

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