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Social care should be free at the end of life, says Health Committee

Social care should be free at the end of life, according to a new report from the Health Select Committee.

The report from the cross-party group of MPs examined the state of end of life care and found there was "unacceptable variation" in the care received by people in England.

End-of-life care is defined as people expected to die within 12 months and most people in need of it have an incurable or progressive illness.

In the report, which looked into end-of-life care since the independent review of the Liverpool Care Pathway chaired by Baroness Neuberger, the MPs strongly recommended that the government provide free social care at the end of life “to ensure that no-one dies in hospital for want of a social care package of support”.

Care minister Norman Lamb said the government was examining the merits of providing such care.

"We are looking carefully at the costs and benefits of this policy, but we know that thanks to the hard work of health and care staff and carers, many people already receive good end-of-life care.

"We are determined to improve further, and by April, 70% of clinical commissioning groups should be capable of using electronic records to share end-of-life care choices across the health and care system so people's wishes can be respected."

The report, based on evidence from clinicians, charities and palliative care experts, also found "great variation in quality and practice across both acute and community settings". It recommended that a senior named person in each NHS Trust be given responsibility for monitoring how end of life care is being delivered within their organisation.

Committee chair Dr Sarah Wollaston MP said: “There are unacceptable levels of variation in the care that people receive and this needs to be addressed so that high quality end of life care is available to everyone regardless of their age, medical condition or where they live. We must make sure that specialist palliative care expertise is accessible within hospitals and community settings as well as within our hospices."

The report also found that many staff lack the confidence, skills and training needed to raise end of life issues with patients. It recommends that those who deal with palliative care should be given extra training on care planning and the different models and forms that are available to patients.

Other recommendations in the report include the use of electronic care planning and investing in community nurses and specialist outreach palliative care so those who would like to can die at home.

The MPs also believe that bereavement support for families should also be included as part of end of life care but availability is currently fragmented and inconsistent around the country.

They also call for the government to address the issue of sustainable, long term funding for the hospice sector in its response to the Palliative Care Funding Review.

Dr Jane Collins, chief executive of charity Marie Curie, said the current situation had to change.

"We see a big difference depending on the diagnosis, so you're more likely to get good care if you have cancer.

"The majority of people say they do not get the care and support they need and still around half of people in the UK die in hospital despite this being the more expensive option and the place where most people say they would not want to die.

"The challenge for the next government is clear - there needs to be a dramatic improvement in access to high-quality care in the community, available for people early on in their illnesses so that they can live well and stay out of hospital for as long as possible."

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