People who are dying do not always getting good quality end of life care because commissioners do not understand the needs of specific groups, a report has revealed.
According to the Care Quality Commission (CQC) report, A different ending: Addressing inequalities in end of life care, one-in-three clinical commissioning groups (CCGs) has not assessed the end of life needs of their local populations.
People who are dying do not always getting good quality end of life care because commissioners do not understand the needs of specific groups, a report has revealed.
According to the Care Quality Commission (CQC) report, A different ending: Addressing inequalities in end of life care, one-in-three clinical commissioning groups (CCGs) has not assessed the end of life needs of their local populations.
Just 18% of the CCGs surveyed by the CQC had commissioned specific services for vulnerable people, older patients and those with a learning disability, mental health problem or a progressive illness other than cancer.
The CQC said: “In many cases a lack of understanding of people’s needs is still preventing people from receiving good end of life care.”
The needs of the homeless, gypsies and travellers and people with a learning disability who are often excluded from wider health services are not always considered by commissioners, the report found.
A lack of understanding from services and staff had also affected some lesbian, gay and transgender patients and people from black and minority ethnic (BME), the report found.
A lack of appropriate commissioned services means“people may end up dying in hospital when they would have chosen to be cared for somewhere else,” the report found.
Some commissioners are failing to meet their obligations under the Equality Act 2010 to consider the needs of different groups in the community or the Mental Capacity Act 2005, warned the CQC.
It said: “it is concerning that barriers to accessing services are not being recognised or addressed in some areas.”
It called for “a strategic equality-led approach at local level.”
Some patients with terminal illnesses other than cancer “seem left out in the cold” and were not getting appropriate end of life care, relatives told the CQC.
Professor Steve Field, the CQC’s chief inspector of general practice said: “A person’s diagnosis, age, ethnic background or social circumstances should not affect the quality of care they receive at any point, but certainly not at the end of their lives.”
The report pointed to good practice such as Central Manchester CCG’s care for socially excluded groups.
Field said: “We found that where commissioners and services are taking an equality-led approach, responding to individual’s needs, people receive better care.”
Phil McCarvill (pictured), deputy director of policy, NHS Confederation, said:
"The whole system needs to work together to ensure that we are prioritising end of life care and are putting the wishes of people at the centre of care.”
Professor Bee Wee, the national clinical director for end of life care for NHS England said it encouraged CCGs to “study the findings to understand and address variation in local areas.”
