Leading researchers are urgently calling for major reforms to the UK’s system of palliative care in response to a significant and persistent increase in demand caused by the Covid-19 pandemic.
Researchers at Cicely Saunders International – the leading charity supporting palliative care – have published You Matter Because You Are You, a seven-point Palliative Care Action Plan that identifies the major challenges now facing the palliative care system, and outlines evidence-based solutions for each of them.
During 2020, demand for palliative care surged, reaching levels of need similar to those which had previously only been expected to be reached in 2040. The wide-ranging impact of the pandemic on NHS services – including delays to surgeries and consultations, an increase in long-term conditions and changes to how health and social care is delivered – is anticipated to result in a sustained increase in demand for palliative care, exceeding previous forecasts.
The accelerated demand has highlighted and exacerbated existing shortcomings in the palliative care system, compromising patients’ care and affecting families and carers. The researchers say that urgent reforms are now vital to bring the palliative care system up to speed with new levels of demand.
The researchers warn that patients currently do not have enough choice or control over decisions taken about their care. Too many people with life-limiting illnesses – as well as those approaching death – are spending long periods of time in hospital unnecessarily, without the option of an alternative care setting. Meanwhile, hospital admissions have been rising to unsustainable levels across the country – and risk overwhelming parts of the NHS during the Covid-19 pandemic.
A lack of coordination and information-sharing between health and social care providers is restricting patients’ choices and compromising the quality of their care. The shortage of palliative care expertise, especially in social care and community settings is further compromising patients’ experience.
The Action Plan draws on research carried out by Cicely Saunders International during the pandemic, as well as evidence from Government-commissioned reviews and independent reports. It sets out 24 achievable actions, each designed to improve the care patients receive and increase the efficiency of NHS services, ensuring the palliative care system can cope with the accelerated demand.
The Action Plan advocates a holistic approach to improving the provision of palliative care, identifying challenges and solutions across the health and social care system. It recommends reforms to the care delivered in hospitals, hospices, care homes, patients’ homes and in the community, as well as calling for an overhaul of the education and training for health and social care professionals, and greater investment in research.
A primary focus of the Action Plan is to increase and facilitate the provision of palliative care in all healthcare settings, in order to improve patients’ experience and alleviate pressures caused by unnecessary hospital admissions.
Professor Irene Higginson, Scientific Director, Cicely Saunders International, said:
“The Covid-19 pandemic has made it clear that when the demand for health and social care services goes up, the provision of palliative care falls short. The demand on NHS services we saw during 2020 is unprecedented, but it is also an indication of the challenges we will face in the future. We need to start preparing for those now, as we respond to and recover from the lasting impact of the pandemic. It’s vital that we learn from this experience and implement the changes necessary to secure high quality palliative care for all patients.”
John McGrath, Chair, Cicely Saunders International, said:
“This landmark action plan draws on excellent independent reports – including Government-commissioned reviews – into palliative care. The value of getting palliative care right – for patients, families, carers and the NHS – has long been recognised, but systemic issues remain, hindering healthcare professionals’ work and compromising patients’ care. These issues are being exposed by the accelerated demand for palliative care caused by the Covid-19 pandemic, and must urgently be addressed.”