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Gold, incentives and meh

End of life care condemned by spending watchdog

By Emma Wilkinson

End of life care has been criticised by a National Audit Office report which found too many people end up dying in hospital when they want to die at home.

A lack of support to help keep people at home or in care homes resulting in unplanned and unwanted admissions to hospital in the final days of life, the report said.

Only 29% of doctors have had training in end of life care and there is a wide variation in spending on palliative care – from £154 to £1600 per patient between different trusts, the NAO added.

It also cast doubt on government plans to improve services which were announced earlier this year.

Tim Burr, head of the National Audit Office, said: 'Organisations responsible for the care of people approaching the end of their life need to improve the planning and delivery of services, particularly support in the community.

'There is scope to make these improvements by using both existing and planned additional resources more efficiently and effectively.'

Speaking on BBC's Today programme, RCGP chair Professor Steve Field said GPs were not getting enough training.

'GPs would sympathise – we want people to be able to die where they want to but this is about co-ordination of services.'

He added that good palliative care teams were patchily distributed around the country.

Dr Mike Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon said giving up 24-hour care was partly to blame for a lack of co-ordination but through practice-based commissioning GPs could take back responsibility for ensuring patients wishes are adhered to at the end of life.

'I know that some PCTs have plans to increase the number of people who die at home but PCTs often aren't close enough to the ground to know what's going on.

'The answer is give it back to the practices as commissioners to ensure patients can die at home if they wish.'

The National Audit Office said too many patients who wanted to die at home ending up in hospitals

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