First Atlas of variation in palliative and end of life care for England

Categories: Research.

Public Health England (PHE) has published the first Atlas of variation in palliative and end of life care for England which shows significant differences in care provision across the country.

Almost half a million people die each year in England – around one person per minute. The Atlas – the first of its kind – highlights local challenges in indicators of need and care provision.

With the UK’s ageing population rising each year, the data provides an insight into death and its impact on people and their families and illustrates the need to move away from a one-size-fits-all approach to more tailored patient and family focused care.

The number of people dying and their age at death is increasing – 40% of people who die now are aged 85 years or older. Older adults need a very different focus in their end of life care because of their physical frailty, multiple medical conditions often including dementia and complex care needs.

The numbers of people dying with dementia has increased most rapidly but the numbers vary across England as a percentage of all those who die. In some areas it is as high as 1 in 4 people (23.8%) compared to the lowest area 12.3%.

Despite remaining the most common place, the number of hospital deaths has decreased by 11% to 46.7% in 2015. However, there is concern about the percentage of people admitted to hospital as an emergency three or more times in their last 90 days – which can affect 1 in 10 people in some areas.  Some of these admissions could be avoided by better community care planning and if not necessary can be distressing for patients and their families.

The Atlas contains 29 indicators of need for palliative and end of life care, such as causes of death and indicators of the quality of care in hospitals and in the community. It also contains 29 maps exploring palliative and end of life care over three sections, namely: the need for palliative and end of life care, the role of hospitals in palliative and end of life care and palliative and end of life care in the community.

The Atlas provides a useful palliative and end of life care resources section which signposts key guidelines and policy statements. This together with information on local performance can be used to highlight and improve services.

The Atlas contains useful resources on palliative and end of life care. For example, such as CCG and local authority End of Life Care Profiles and End of life care data to inform Sustainability and Transformation Partnerships (STPs).

PHE envisages that commissioners and service providers will use the Atlas combined with their local knowledge and intelligence to develop solutions that can work to improve the provision of palliative and end of life care for their population.

You can download the resource at Atlas of variation for palliative and end of life care in England