Times writer: how the NHS failed my dying dad

Dying patients are not being treated with the dignity and respect they deserve, an official report has concluded.

Health and social care services are failing elderly and terminally ill patients in England as many are not being offered the option of dying at home, rather than in hospital, the National Audit Office (NAO) said.

Just one in five of the deaths in England - most of which follow chronic illness such as heart disease, cancer or dementia - occur in a person’s home, despite two thirds of people saying that that is where they would prefer to die.

The Government published an End of Life Care Strategy earlier this year which pledged to enable more terminally-ill patients who wished to die at home to do so, but the NAO says that there are widespread variations across the country in the funding and quality of palliative care.

Many patients ended up being needlessly admitted to hospital, where they are dying on general wards because information about their wishes is often not captured or shared, it adds.

Karen Taylor, director of health studies at the NAO, said that, in general, “services were not meeting people’s needs” and described coordination between health and social care staff as “poor”.

Some local NHS primary care trusts (PCTs) spent just £150 per person on specialist palliative services while others spent nearly £1,700 per person in 2006-07, the report adds. The average for the 151 PCTs surveyed by the watchdog was £504 per patient.

More support should be given to help people to stay in their own homes or to get home quicker after a hospital stay, she added, as an estimated £104 million could be saved if emergency admissions were cut by a tenth and the average length of hospital stay was reduced by three days where people had no medical need to remain there.

Tim Burr, head of the NAO, added: “Good end of life care should mean that people are treated with dignity and respect and, where possible, in their preferred place of care.

“Some people receive high standards of care in their final weeks, days and hours, but others do not.”

He said organisations need to improve the planning and delivery of services, particularly support in the community, by using resources more efficiently and effectively.

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