By James Sanderson, Chief Executive of the palliative care and bereavement charity, Sue Ryder. As the Assisted Dying Bill continues to be put under scrutiny, so does the state of palliative and end-of-life care in the UK.
This conversation was long overdue and has highlighted an urgent need to improve the provision of care for people who are dying.
The quality of palliative care we deliver in this country is excellent and healthcare professionals within palliative care are some of the most caring and compassionate I have seen. But research overwhelmingly shows that many people are not receiving the palliative care they need due to systemic failures.
When access to care is unavailable or limited, people with terminal illnesses risk unmanaged symptoms, unnecessary pain and isolation in their final days. We do not need to accept this as the way things have to be.
The Need for Radical Change
We welcomed the Prime Minister’s pledge to enhance end-of-life care in the upcoming NHS 10-year plan, as well as the recent investment boost for hospices. These steps indicate what we hope is a long-term commitment to people at the end of life.
However, incremental improvements alone are not enough. Due to an ageing population and people living with multi-mobilities, we need radical approaches to meet the growing demand for palliative care to ensure everyone receives dignified, compassionate support and their needs are met.
The NHS 10-year plan presents a crucial opportunity. Sue Ryder has submitted detailed recommendations to the Government, outlining how we can expand care provision in people’s own homes and hospitals, which will also alleviate pressure on the NHS.
Our vision is to create a new ecosystem for palliative care, one that ensures people can get care, when and wherever they need it.
We have put forward our five-point plan to the Government, on how to build this system. This includes –
- More training for healthcare professionals to improve collaboration and forward planning, this will help patients to record their wishes and plan for the end of life.
- Enhancing community-based care, the hospice sector can work alongside the NHS to create virtual wards, improving coordination among health and social care professionals to deliver personalised, co-ordinated support.
- Integrating hospices into the neighbourhood health infrastructure, ensuring hospice expertise is used to support people approaching the end of life.
- A rethink of the use of NHS CHC Fast Track funding, to help Sue Ryder provide more care in the community and expand the hospice at home provision.
The final point in our plan and one of the most pressing, focuses on the impact of end-of-life care in hospitals, where we believe some of the most significant changes are needed.
Alleviating Pressure on the NHS
Currently, an estimated 9.5 million hospital bed days a year result from an emergency admission of someone in the last year of life, often due to a lack of alternative care options. This places immense strain on the NHS.
Furthermore, 43% of deaths occur in hospitals, despite most people expressing their wish to die at home. The outgoing NHS CEO, Amanda Pritchard, has stated that reducing this figure by just 10% would have the same impact as building three new hospitals.
With demand for palliative and end-of-life care expected to rise by 42% over the next 15 years, the need for a new, well-integrated system has never been more urgent.
Sue Ryder has a solution, one that can free up hospital resources, reduce inequities in care, and provide people with a good death.
New Sue Ryder Model for Palliative Care in Hospitals
Our new model includes a proposal of creating Sue Ryder Alongside Suites within existing hospital grounds and new hospital sites.
The aim would be to identify people in the last year of life, whether in A&E or other parts of the hospital. They would be transferred to our specialist palliative care suites, immediately freeing up acute hospital beds.
Designed to emulate the homely and non-clinical feel of our hospices, these suites would offer specialist palliative care paired with peace, privacy, and comfort.
Once in Sue Ryder’s care, we can make sure people get the right support to discharge them back into the community, helping to implement the Government’s vision and, more importantly, ensure that people who wish to spend their final days at home can do so with the necessary care.
For those who cannot be discharged, our “home-from-home” hospice suites would provide a calm, compassionate, good death – a far cry from a busy, noisy hospital ward.
By integrating this model into hospitals, we can also address disparities in access to palliative care. Hospitals serve a broad demographic, meaning our approach would ensure that end-of-life support reaches people who the sector is currently not reaching.
Making it Happen
The Sue Ryder Alongside suites will not replace existing hospices, which remain an essential part of the palliative care system. Instead, they will complement and expand current support, ensuring that more people receive appropriate care earlier in their final journey.
This initiative can be co-funded by the charitable sector and on a tariff basis by the NHS, ensuring long-term financial sustainability.
Collaboration with NHS estates will be key in identifying suitable locations for Sue Ryder hospice suites. The necessary space exists, and we strongly advocate for these suites to be considered into new hospital development plans. The hospice sector and its fundraising partners could provide the initial investment needed to transform these units into comfortable, “home-from-home” spaces, we believe are so vital.
We see independent hospices as key to this model and want to work with them to use everyone’s expertise to development a new, integrated system – one that benefits patients, families, and the NHS.
A Feasible Solution
This model will not only make a huge difference, but it is achievable.
We hope to see this vision reflected in the Government’s 10-year plan for the NHS. By taking decisive action now, we can revolutionise palliative care in the UK and make it the best in the world. Offering more people dignity, choice, and comfort in their final days, while supporting the NHS.
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