We then asked recently bereaved families and carers to help identify the issues that we should focus on.įamilies and carers told us that good quality end-of-life care includes: consistently caring, as well as clinically competent, staff good communication and involvement, for example, in care planning information about what to expect, what services are available and how to access them and seamless, co-ordinated care that adapts as people’s needs change. We reviewed literature and engaged with stakeholders to build up a picture of end-of-life care at home. We make recommendations for commissioners, integrated care boards (ICBs) and national bodies to ensure the opportunity is grasped.
Developing integrated care systems (ICSs), a new statutory duty for commissioning end-of-life care, and new ways of working create potential for commissioners to develop end-of-life care as an integrated service with patients and carers’ needs at its heart. There is a moment of opportunity for commissioning end-of-life care.
They were not making full use of available data or national resources for assessing local needs, and were not monitoring quality across health and social care.Īll commissioners recognised the importance of inequalities in end-of-life care, but none had yet started taking action to reduce them. We interviewed NHS commissioners in 10 areas of England, and social care commissioners in a further 5 areas, to find out how they assess need, plan services and assure the quality of care for people who die at home.Ĭommissioners had limited ability to assure the quality of care for people who die at home. This raises questions about whether there are the right staff with the right skills to support people in their home at the end of life, and whether the health and care system is prepared for changing levels of demand. Increasingly people are dying at home rather than in hospital and this trend is set to continue.
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