THE NHS is to raise the profile of the treatment of patients who die in its care, after the Government acknowledged that there needs to be a cultural change in how society and the health services approach the subject of death. It says that it would like to give people more choices in the place of their death.
The Health Minister, Alan Johnson, announced the initiative last week, when he launched the Government document End of Life Care Strategy for England. It says that half a million people die every year in England. Two-thirds of them are over 75, and most die of chronic illness; 58 per cent die in hospital, and only 18 per cent in their homes.
A century ago, however: “People were familiar with death: many people died at home; they died of diseases at a young age,” Mr Johnson said. Now they died in hospital, whether they wanted to or not, “and sometimes there are issues about how they die in hospitals. The big issue for us is to give the choice to everyone.”
In launching its strategy, the Government is calling for a “step change” and a “cultural shift” in the way people nearing their death are treated. The report says that the NHS has received thousands of complaints from carers and relatives, alleging that it has failed to provide the basic comfort, privacy, and psychological care their loved ones needed. Families said there had been poor communication, and often little or no specialist palliative care.
“Relatives frequently commented that they seemed to be the first to recognise that the patient was dying. Inappropriate, invasive procedures were often undertaken, even in the dying phase,” the report says.
The new strategy aims to involve the patients and their families and carers in plans for the last period of life. It includes helping patients spend their last days at home if they wish, supported by medical and nursing services.
It says “spiritual care” must run alongside medical and physical care, and that chaplains should be a “core” part of the team. It wants a “robust” attitude from hospitals towards their collection of information about a person’s religion. They should keep a written record about religion, and the information should be passed on to the chaplain if the patient wishes.
The report suggests that medical, nursing, and support staff need to develop an awareness of people’s spiritual needs, and of the various religious expectations and rites, as part of their “core training” in how to deal with an impending death.
The strategy has allocated an extra £286 million to fund a range of palliative-care services. This includes building chaplaincy teams to meet the spiritual needs of people of all faiths and none, and bereavement-support services. The report acknowledges, however, that there are times when some patients insist on seeing “an accredited minister of their own faith or Church”.
The Bishop of Gloucester, the Rt Revd Michael Perham, had been on the advisory board that developed the strategy, a health department spokeswoman said.
End of Life Care Strategy for England can be downloaded from www.dh.gov.uk
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