A landmark for choice at the end of life

On Thursday the Department of Health published a seminal report on promoting choice in end of life care. Five years in the offing, the independent Choice Review Board was formed last July with the remit of making sure that adults at the end of life, their carers and family have more choice.


Although it received little fanfare, due to the publication of the Savile Report on the same day, this report, entitled “What’s important to me. A Review of Choice in End of Life Care”, has done a great deal to advance the agenda for choice at the end of life.

Since 2010 numerous reports have pointed to the number of people who want to die at home (79%) compared to the low numbers that are actually able to (21%). These reports have also highlighted issues with bed blocking and unnecessary Accident & Emergency admissions, which put pressure on hospitals. The reports, including from the Nuffield Trust, Deloitte and Macmillan, all suggest that providing care in the community would be at least cost-neutral if not cost saving.

This report goes further and makes a number of specific recommendations, including placing a deadline of the year 2020 for the delivery of choice at the end of life. Other key recommendations include; the 24/7 provision of care, because people don’t only have issues during the hours of 9 and 5; the recording or people’s preferences and sharing those preferences with people delivering care, because professionals need to know people’s preferences in order to meet them; and free social care at the end of life, which is key to give people that little extra bit of support to allow them to die at home.

This report is incredibly timely, the current Government can still act to put in place some of the recommendations to make choice a reality. But with political party manifestos in the final stages of development ahead of the upcoming General Election, this report can also be incredibly influential on the offers that we see from each of the parties on end of life care.

Regardless of who forms the next Government, it is imperative that end of life care is prioritised. Currently around 480,000 people die each year, but this is expected to increase to 550,000 by 2035. The end of our lives is a time we will all face and we need to work to ensure that it is as comfortable and easy as possible now, not only for those people we will lose in the next Parliament but for generations to come.


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