Commissioners and providers of palliative and end of life care need to take a more proactive approach to tackling inequalities in care to ensure that people of all ages in their diverse local communities receive the support they need, according to a new resource published today.
The resource – called ‘Care committed to me’ – focuses on three specific groups: Lesbian, Gay, Bisexual and Transgender (LGBT) people, those experiencing homelessness and Gypsies and Travellers.
It shows how commissioners, service providers and health and care staff can successfully deliver high quality, personalised care to people from these groups by taking proactive measures to overcome many of the challenges that prevent them receiving the care they need.
The new resource aims to put into practice the six commitments made by the Government to end variation in end of life care across the health system by 2020. It has been produced by the Voluntary Community and Social Enterprise (VCSE) Health and Wellbeing Alliance (HW Alliance) A partnership arrangement funded by the Department of Health and Social Care, NHS England and Public Health England.
For example, it highlights how strengthening links between hospices and hostels can make a notable difference to homeless people living with a life-limiting condition.
St Luke’s Hospice in Plymouth developed a partnership with a local hostel to train hostel staff to support people at the end of life, identify more people who need this care and help develop local networks across the homelessness, health and social care sectors to provide more integrated, better targeted support.
Based on a range of approaches taken by different organisations working with the three groups – which successfully widened access to care- the new ‘Care committed to me’ resource identifies five principles of good care. They are:
- Good communication which includes engaging with people in a way that is meaningful for the individual and so enables people to make informed decisions about their care
- An approach founded on dignity and respect and investing in a relationship of trust
- The provision of workforce training and support
- Enabling partnership working at a strategic level
- Recognising that people are all different, so inclusive, equitable care is not about treating everyone in the same way
The resource also highlights the need for better data about different end of life care needs in local communities- to support effective and more targeted commissioning of services.
It calls for more to be done at local level, including for the three groups identified in the report to be included in local Joint Strategic Needs Assessments – which look at the current and future health and care needs of local populations.
Also for tackling inequalities in end of life care to be identified as an action in local Health and Wellbeing Strategies.
Commenting on behalf of the project group, Hospice UK’s Chief Executive Tracey Bleakley said:
“Everyone approaching the end of life in the UK, no matter who they are, should receive high quality, timely care. However, there are still glaring inequalities in access to end of life care and sadly too often people from groups in our society are shut out from the support they need, whether due to stigma or systemic organisational barriers.
“Hospices are championing an equality-driven approach to end of life care and many have successfully expanded access to their services to better support the diverse needs of their local communities. However, there is much more to be achieved.
“Hospice UK is committed to sharing the learnings from this insightful resource with other hospices and together continue our efforts to make access to end of life care more equal.”
The new resource focuses on three of the groups identified in an earlier report by the Care Quality Commission (CQC) on inequalities in end of life care in England which was published in 2016.
Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said:
“Good care is person-centred and responsive to the needs of the individual – no matter their circumstance or background, everyone has the right to high-quality, compassionate care.
“As a GP and as Chief Inspector of General Practice, I have seen how services, healthcare professionals and third sector organisations like hospices can work together to make sure that people whose voices are rarely heard are listened to and supported.
“However, there is huge variation in the quality of care that people receive at the end of their life. For everyone to access the care that they deserve, healthcare services and the wider system need to grasp the vital roles that they have to play at a local and strategic level. Without this, we risk missing the opportunity to improve the quality, and importantly the co-ordination, of care for those people who may be vulnerable, socially excluded or seldom heard.”
The new resource is part of a multi-organisational project led by Hospice UK, Marie Curie and Together for Short Lives and is funded by NHS England, the Department of Health & Social Care and Public Health England. They worked with partner organisations Homeless Link, the National LGB&T Partnership and Friends, Families and Travellers (FFT).
The project is part of the Voluntary Community and Social Enterprise (VCSE) Health and Wellbeing Alliance (HW Alliance). The HW Alliance is a partnership between voluntary sectors and the health and care system to provide a voice and improve the health and wellbeing for all communities.