"Report by the Comptroller and Auditor General, HC 1043 Session 2007-2008, 26 November 2008"
"Ordered by the House of Commons to be printed on 24 November 2008"
This National Audit Office report, "End of Life Care (HC 1043)", finds that some people approaching the end of their life receive a high quality service but that there is room for improved coordination between health and social care services in planning and delivering end of life care. The provision of end of life care is becoming increasingly complex, with people living longer and the incidence of frailty and multiple conditions in older people rising. Information on peoples' wishes is often not captured or shared and a lack of services to support them at home may lead to unplanned and unwanted admissions to hospital. In 2006-07, estimated expenditure on specialist palliative care varied considerably between Primary Care Trusts (PCTs), from GBP 154 to GBP 1,684 per death. While there are no complete data on the total cost of end of life care, the National Audit Office estimates that the cost of caring for the 27 per cent of people who die from cancer is GBP 1.8 billion in the last year of their life. The majority of people approaching the end of their life wish to be cared for outside of hospital, so reducing the amount of time they spend there unnecessarily could make resources available to support these people more effectively in their preferred place of care. Frontline staff often lack training in delivering basic end of life care. Only 29 per cent of doctors and 18 per cent of nurses received pre-registration training in end of life care and there is a lack of formal training for staff working in care homes. Positive experiences of care were often linked to being treated by staff who understood, appreciated and empathised with the end of life situation. (source: Nielsen Book Data)