70 Years of End of Life Care in the Community

A new report on palliative and end of life care in the community has been published by the Queen’s Nursing Institute and Marie Curie.

The two charities published the findings of their national survey of health and care staff in December 2023. The survey was inspired by a similar joint project undertaken by the two charities in 1952, which was very influential in the development of the hospice movement in the UK.

The survey findings reflect how palliative and end of life care has changed in the last 70 years, and shines a light on the challenges being faced in delivering high quality care. Despite huge advances in medicine and care delivery, services are still being hampered by many of the same social and economic ills as in the 1950s, and by a lack of resources at this crucial time in people’s lives.

The report includes a Foreword by the chief executives of the two charities, and four key Recommendations for policy makers.

Dr Crystal Oldman CBE, the QNI’s Chief Executive commented:

“Nurses working in the community know that they only have ‘only one chance to get it right’ when it comes to end of life care. Working with families is at the very heart of community nursing but as this report highlights, many frail older people are living alone. Having the right resources in place, alongside careful advance planning, are absolutely critical. If not properly resourced, there are huge risks inherent in services’ capacity and capability to deliver high quality palliative and end of life care.

“Community nurses are the expert coordinators who manage this care, but there are simply not enough of them to meet the needs of everyone in our communities. District Nursing was conceived as a universal service, but it is struggling to meet the growing demand of an ageing population. It is absolutely essential that more resources are allocated, if we are to avoid the tragedy of unmet palliative and end of life care needs.

“The clear evidence presented in this report should be a wake-up call for politicians of all parties. Healthcare provider organisations are well aware of the challenges they face, and community nurses have continued to manage ever larger and more complex caseloads, and they deserve admiration and praise for that.

“But this way of working is not sustainable for nurses, the individuals and families served or for the system as a whole. I think there would be no disagreement in society that palliative and end of life care services should be properly resourced, for everyone, when they are in time of need. In the same way that we need specialist and fundamental care at the beginning of life, palliative and end of life care is a service that nearly every citizen will need one day.

“The extent to which our politicians are prepared to support the recommendations in this report might be seen as a measure of our respect as a society for human life.”

Links and Notes

Read Dr Emma Carduff’s blog on Marie Curie’s website: https://www.mariecurie.org.uk/blog/food-banks-and-loneliness/376376

To download the report, go to: https://www.mariecurie.org.uk/globalassets/media/documents/policy/policy-publications/2023/1952-report-final.pdf

The QNI‘s contribution to this project included historical analysis, development of the survey questions, promotion of the survey to community nurses, interpretation of the survey results and input to the final report.

With thanks to Professor Alison Leary MBE, Dr Ben Bowers QN, Dave Bushe, and all community nurses who completed our survey.