Palliative care leaders have urged the Government to turn words into action by funding the transformation of end-of-life services in the Budget. Marie Curie, Sue Ryder and Hospice UK are among organisations calling for a £200million per year fund to ensure more families receive high quality care and support.
It comes after Prime Minister Andy Burnham said palliative care needed to be fixed before a debate about legalising assisted dying could take place. Many MPs and parliamentarians cited the dire state of underfunded end-of-life services as a reason for voting against the Terminally Ill Adults (End of Life) Bill.
Dr Sam Royston, Marie Curie’s director of policy and research said: “Now is the absolute critical time for all of those words that have been shared about the state of palliative care to turn into action. The Prime Minister himself said that palliative care is not in a good enough state, it needs fixing.
“This has to be an urgent priority for the Government. We need it to be taken seriously. The Budget provides a great opportunity for them to do something about it.”
Research by Marie Curie has found almost one in three people die without end-of-life care, a figure expected to rise by 24 % by 2050 due to a rapidly ageing population.
Dr Royston described the current provision of palliative care across the country as “a complete patchwork”, with “bits and pieces of care being provided in different ways in different places”.
A lack of support in the community too often leads to patients ending up in hospital for days, weeks or months, when they would rather be at home. Some 56% of all healthcare expenditure on people in their final year of life goes towards emergency hospital care, while only 11% is spent on primary and community care.
The Government has already set an ambition to reduce unplanned hospital bed days by 10% over the coming three years. And ministers are expected to publish a full Modern Service Framework (MSF) for Palliative and End-of-Life Care in England this autumn, which will set out planned reforms and targets.
Dr Royston said such ambitions would only be realistic if the plan is backed by sufficient funding to allow local health chiefs to commission the services their area needs.
He added: “Part of the purpose of this transformation fund is that it should be up to individual health commissioners to make the call on what works for their local area. There are so many examples of good practice to choose from across so many different settings.
“If what we end up with is just another plan that’s going to sit on a shelf and nobody will be able to act on it because there’s no money to actually deliver it, then it would be simply outrageous. Setting that up with the money to deliver it in the Budget would be a really big step forward.”
Marie Curie’s call for a £200million per year “transformation fund” has also been backed by several medical royal colleges, including the Royal College of Emergency Medicine, Royal College of General Practitioners and Royal College of Nursing. Other backers include Age UK and the British Geriatrics Society.
James Sanderson, chief executive at palliative care and bereavement charity Sue Ryder, said the plan “could be a once in a generation chance to make sure all dying people receive the right care”.
He added: “When someone with terminal illness is in pain and without support in the middle of the night, it is the loneliest and scariest place to be. When someone is dying in a busy hospital corridor and their loved ones don’t have the privacy to say goodbye, they feel helpless, fearful and even guilty.
“This isn’t the end of life that we would want for the people we love, but it is the reality for far too many people. Before the year is out, we need to see its plan, and in the Budget, we need to see the financial commitment to make that plan a reality. Otherwise, the people we love will continue to suffer needlessly.”
Hospice UK also backed the call for investment and is separately calling for an immediate £112.5million investment to help the ailing hospice sector. This amount would be the first quarter of £450m the charity believes is needed to fully fund specialist palliative care provided by hospices.
Charlie King, director of external affairs at Hospice UK, said: “Too many hospices are being pushed to breaking point, with vital services being cut and seriously ill patients and their families at risk of missing out on the care they desperately need.”
Government funding covers on average only 40% of the care provided by adult hospices and a third of the cost for children’s hospices, according to the charity. There is also wide variation – some hospices receive as little as 3% of their funding from the state, while others receive as much as 80%.
Three quarters of hospices in England were already running at a deficit in February and almost six in 10 had either made or were considering cuts to frontline services, research suggests.
Mr King added: “Hospices rely heavily on the generosity of local communities to keep essential services running, but charitable fundraising alone cannot sustain the care that patients and families depend on. We urgently need a fairer, more sustainable funding system.
“The Chancellor must use this Budget to act. We are calling for an immediate £112.5 million a year funding boost, alongside a long-term commitment to fully fund specialist palliative care, fair NHS contracts and support for staff pay.
“No one should face the end of their life worrying about whether the care they need will be there. The Government must stop leaving hospice care to chance.”
A Department of Health and Social Care Spokesperson said: “Hospices provide vital care and support for people and families at the most difficult time in their lives. We have backed the sector with the biggest investment in a generation, including £125 million to improve hospice facilities.
“We recognise the financial pressures many hospices are currently facing and are working with the sector and NHS partners to create a more sustainable funding approach, so patients and families can continue to get the care they need.
“The Prime Minister and Health Secretary have made clear their commitment to improving palliative care, which will help address some of the most significant challenges facing the sector, including regional variations in access and quality, gaps in support, and workforce shortages.”
