The Raven's Blog

12.10.17

Dying well is a public health issue

Ahead of the King’s Fund Annual Conference (29-30 November) on population health and prevention, Dr Jane Collins, chief executive of Marie Curie, explains why dying well is a public health issue.

The idea that how people die can and should be seen as a public health issue is one that might seem strange to many people. After all, public health initiatives are traditionally a means to keep people healthy for longer and to prevent them getting ill.

Of course, we all die, and because most of us are living longer we are highly likely to die with one or more life-limiting conditions. This isn’t a public health failure – it’s an inevitability in our ageing society – and many people believe that public health still has an active role to play in supporting people to die well.

This is the argument that Allan Kellehear, professor of end of life care at University of Bradford, has made throughout his career and in particular his concept of compassionate communities. In his view, local government has a very important role to play in helping communities to better support not just people who are dying, but also their carers and families.

This has the potential to have a huge impact not just in the lives of individuals but also in the way a community uses health services, particularly hospital care. A very common experience of people at the end of life is a ‘yo-yo’ of emergency hospital admissions, often without clinical need, that can, in some cases, lead to prolonged stays and death in hospital.

There are many factors that cause this such as a lack of access to palliative care in the community and difficultly in sourcing appropriate social care. However, carers struggling to cope is a huge factor, especially when they are not only providing care themselves but also co-ordinating a host of health and social care services.  We have seen this through the research we have fundedbut also from the many carers that we support across the UK. They tell us that caring for someone at the end of life is the most isolating experience they’ve ever had – their mental and physical health is under constant pressure. 

You can see where a public health approach can become vital in this situation. If a community is prepared to break down that isolation and provide a carer with a support network, perhaps even spreading the caring duties over a number of people, then it is more likely that a crisis can be averted.

In many ways, this approach is about trying to regain something that we have lost as a society. At the turn of the 20th century most people died at home – not in the best conditions, to be sure, but with the support of family, friends and community. Hospital deaths rose throughout the century, peaking at close to 90% in some parts of the West. Through the work of the hospice and palliative care movement, hospital deaths are on the way down, but slowly – and these gains are fragile in the face of demographic realities.

To really achieve better outcomes for people at the end of life, we really need to pair innovative services with a compassionate communities approach, so that carers and family are supported both in the services they access and by the people that are around them on a day-to-day basis. Neither one can truly help us meet the challenge posed by more people dying with more complex conditions on their own.

FOR MORE INFORMATION
Dr Collins is chairing day two of The King’s Fund Annual Conference (29-30 November). For more information about the event, visit www.kingsfund.org.uk/annual17.

(Top image c. LPETTET, iStock)

Comments

There are no comments. Why not be the first?

Add your comment

 

related

public sector executive tv

more videos >

latest public sector news

Council controversially begins first monthly bin collection in England and Wales

25/09/2018Council controversially begins first monthly bin collection in England and Wales

Monthly bin collections have been introduced for the first time in England and Wales by Conwy County Council, despite major complaints from resid... more >
Nottinghamshire leader hits back: ‘We’re the most transparent and open council there is’

25/09/2018Nottinghamshire leader hits back: ‘We’re the most transparent and open council there is’

The leader of Nottinghamshire County Council has hit back against claims that the authority lacks transparency, claiming that the council is &ldq... more >
Exclusive: Notts leader rejects calls for council merger referendum, public decision due in May

25/09/2018Exclusive: Notts leader rejects calls for council merger referendum, public decision due in May

The leader of Nottinghamshire County Council has rejected calls from opposing councillors to put potential merger plans to a referendum, arguing ... more >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this... read more >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the o... more > more last word articles >

the raven's daily blog

Social value: what is it and why?

14/09/2018Social value: what is it and why?

Ben Carpenter, chief executive of Social Value UK, discusses the worth of social value, and argues that, before we start measuring social value, we should ask clearly: what is it, and why? Social value is so much more than a value for money exercise. If you see social value as simply a new catchphrase for ‘efficiency savings’... more >
read more blog posts from 'the raven' >

comment

Crown Commercial Service: Travel solutions on track

10/09/2018Crown Commercial Service: Travel solutions on track

Katrina Williams, head of travel at the Crown Commercial Service (CCS), explains how they are helping government organisations to get the best de... more >
LEPs need to do more for England's countryside

10/09/2018LEPs need to do more for England's countryside

Paul Miner, head of strategic plans and devolution at the Campaign to Protect Rural England (CPRE), highlights the findings of a recent survey wh... more >
What about social care?

10/09/2018What about social care?

Cllr Izzi Seccombe, chairman of the LGA’s Community Wellbeing Board, looks at the exclusion of social care from the government’s rece... more >
Re-evaluating public service reforms

10/09/2018Re-evaluating public service reforms

Chris Painter, professor emeritus at Birmingham City University, explores the paradox of reform principles persisting despite mounting evidence a... more >

interviews

Michael King: Time for Ombudsman reform

06/08/2018Michael King: Time for Ombudsman reform

Michael King first joined the Local Government Ombudsman service back in 2004 as deputy ombudsman. At the start of 2017, he was appointed as the ... more >
Helping a city understand itself

06/08/2018Helping a city understand itself

SPONSORED INTERVIEW The urban landscape is changing. How can local authorities keep up with citizen behaviour? Stephen Leece, managing directo... more >
Modern policing: the future is bright

06/08/2018Modern policing: the future is bright

SPONSORED INTERVIEW The public sector, and policing in particular, has often been criticised as being slow to adapt to change. But now, says L... more >
Data at the heart of digital transformation

03/04/2018Data at the heart of digital transformation

SPONSORED INTERVIEW Grant Caley, UK & Ireland chief technologist at NetApp, speaks to PSE’s Luana Salles about the benefits of movin... more >

public sector focus

View all News