Charity calls on government to increase end of life care funding

The Gold Standards Framework (GSF) have explained the need to provide more funding for end-of-life care is urgent as more people are dying at home rather than in hospital.

The charity, which provides training in end-of-life care, has recently commissioned research that highlights 67% of people who expressed a preference for where they pass say they would like to die in their own home or in a care home.

However, GSF highlighted that unless more frontline health and care professionals receive specific end-of-life training to support at-home deaths, the decline in hospital deaths will start to reverse.

If this were to happen, additional pressures could be placed on already stretched NHS services. According to the British Medical Association, the UK, compared to other nations, has a very low total number of hospital beds relative to its population. The average number of beds per 1,000 people in OECD EU nations is five, but in the UK, it is a mere 2.5.

Despite the announcement in March this year claiming NHS England is planning to increase the number of permanent hospital beds by 5,000 within the next two years, the recent NHS workforce plan, which came on Friday, outlined plans to increase the number of health workers in England, by stating the government plans to encourage more people to study medicine at university.

The announcement drew attention to the current severe staff shortages within the NHS, suggesting that even if we were to obtain more hospital beds, there wouldn’t be enough staff members to assist with end-of-life care.

GSF have found that, unlike some developed countries where the majority of people die in hospital, the UK has seen a gradual reduction in hospital death rates – a positive trend that over the last 25 years GSF has contributed to through its end-of-life care training and accreditation programmes.

Alongside campaigning to ensure the government to provide more funding into end-of-life care, the research from GSF also highlighted a lack of public awareness around the subject, with 50% of those surveyed admitting they had scant knowledge of the care and support available to them in their last years of life.

More significantly, 61% said they would appreciate a discussion with professionals about end-of-life care options available. 

Keri Thomas, founder, and Chair of GSF, said: ‘If current trends continue, home and care home death rates are set to almost double by 2040 as hospital death rates decline further.

‘But if end of life training and support for staff in the community does not increase, we are likely to see poorer quality of care for the dying in the community along with increased numbers of hospital admissions and hospital deaths.

‘This leads to increased hospitalisation and reduced access for acutely unwell patients, with the consequent clogging up of emergency departments and long ambulance waits seen in many hospitals last winter.   

‘Research confirms that over 40% of emergency hospital admissions of people from care homes are potentially preventable, and more could be enabled to die at home with better staff training and stronger support.

‘Over 650,000 people died in the UK in 2022 including a 9% rise due to post-Covid excess deaths, with numbers set to rise further in the next 25 years. So failure to provide staff with adequate end of life care training will result in many more people experiencing poor care at the end of their lives, greater distress for their families and excessive hospitalisation. Investment in prevention through proactive training can therefore reap benefits at practical, economic, and humanitarian levels.

‘This overuse of hospitals is not what we or the public wants to see happen. It’s imperative that the government acts now to ensure adequate resources are made available to ensure all frontline staff in any setting receive end of life care training, so that more people can live well and die well in a place and manner of their choosing.’

Image: Claudio Schwarz