Better care for people at end of life in South West

PUBLISHED: 13:19 29 November 2008 | UPDATED: 10:07 10 June 2010

MORE people will be cared for at home in the last days of their lives rather than dying in hospital, as part of a major focus on improving NHS care for those at the end of their lives in the South West.

MORE people will be cared for at home in the last days of their lives rather than dying in hospital, as part of a major focus on improving NHS care for those at the end of their lives in the South West.

A report by the National Audit Office showed that while most terminally ill people wanted to die at home, the majority ended their days in hospital.

About 500,000 people a year die in England, mostly following a period of chronic illness such as heart disease, cancer or dementia. About a third happen at home or in a care home, while 58 per cent die in hospital.

In The South West about three out of five people say they would prefer to die at home, but fewer than one in five actually do so.

Although the South West has the lowest percentage of deaths in NHS hospitals (53 per cent) this is still by far the most common place of dying.

Compared to the rest of England, the South West has a high percentage of deaths in care homes (23 per cent).

Four per cent of deaths in the region occur in hospices.

The South West Strategic Health Authority has already identified End of Life Care as one of its key priorities as part of the Strategic Framework for Improving Health in the South West.

This is the regional blueprint for the future of NHS services in response to the national review of the NHS led by Lord Ara Darzi.

End of Life Care was one of nine clinical working groups which set out a clear vision for improving services in the South West. These include:

*Ensuring that everyone has a choice of where to die, that their wishes are respected and dignity preserved

*Preventing unnecessary admissions to hospital in the final days of life

*Helping people to be free from pain and fear at the end of life

*Community nursing available around the clock

*Nursing equipment and palliative care drugs available at short notice, including out of hours.

Liz Redfern, Director of Nursing and Patient Care at the South West Strategic Health Authority, said: "It can be difficult for people to talk about dying, but we need to get this subject out in the open if we are to provide the best possible care for patients, their relatives or carers, at such a crucial time.

"People with progressive or degenerative illness need to be able to express their preferences before they become too ill, and carers need more support around the clock.

"We know that most people want to be comfortable at home, surrounded by loved ones or carers at the end of their lives, and we are committed to helping them exercise that choice.

"We will be working with GPs and specialist staff to help ensure that people whose lives are coming to an end receive the best possible care in line with their wishes."

A new steering group made up of NHS staff from throughout the South West will hold its first meeting in January to take forward the improvements.

It is expected that responding to people's preferences will lead to a 10 per cent reduction in adult deaths in South West hospitals for each of the next three years.

This is in addition to improvements required as part of the national End of Life Care Strategy launched by the Department of Health.

Phil Hope, Minister for Care Services said: "The Government is committed to improving the quality of care people receive at the end of their lives - we are investing £286 million until 2011 to do this.

"Our Strategy addresses many of the recommendations made in this report, such as taking steps to ensure that services are well coordinated and supporting and training staff, to enhance choice and quality and equality for everyone involved in end of life care.

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