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The National Care of the Dying Audit for Hospitals was led by the Royal College of Physicians (RCP) and has found significant variations in care across hospitals in England. The audit shows that major improvements need to be made to ensure better care for dying people and better support for their families, carers, friends and those important to them.

Katherine Murphy, Chief Executive of the Patients Association has said:

“Inequality continues to distort healthcare in this country. The Patients Association is very concerned about the significant variations in the quality of care provided in NHS hospitals to patients who are at the end of their lives. This stage of their lives can be extremely upsetting and distressing, not only for them, but also for their families and loved ones. It is paramount the family feel involved and engaged with the healthcare professionals at this very sensitive time.   

We receive many calls to our Helpline about poor quality of care for their relatives who are at the end of their life. These include lack of adequate pain relief, patients being put on DNAR notices without consent or involvement from the families and often lack of dignity for patients. Many of our callers feel very guilty for not having done enough for their loved ones and hearing about poor quality of care for their relatives at the end of their life in hospitals will only add to their guilt of and the feeling of helplessness.”

“There are clear guidelines about end of life care plans including the spiritual needs yet the findings of this audit indicate that patients’ end of life care needs are not always being met.”

“We find it alarming that for 87% of patients, recognised by the healthcare professionals as being at the end of their life, less than half of patients were told about this even though they were capable of discussing their care. We would like to express our particular concerns about the way the healthcare professionals communicate with the relatives of patients in hospitals.  There should be clear communication with the family particularly about decisions regarding withdrawal of nutrition and hydration in end stages.”

“We welcome the 10 key recommendations in the report which aim to drive up the quality of care for people at the end of their life across all trusts. In particular, we support the recommendation on mandatory training in care of the dying including communication skills for all staff to ensure that they are competent in supporting the families and carers of patients who are at the end stages of their life.”

“We also welcome the recommendation on the board level accountability and emphasis placed on senior experienced clinicians making difficult and complex decisions about artificial nutrition and hydration involving patients where possible and with their family.”

A high quality, safe care that maintains dignity and respect at all times for patients at the end of their life should be the fundamental principle of care delivery in the NHS.”


Notes for Editors


  1. The Patients Association is a campaigning charity, listening to patients and speaking up for change. It has been working for over 50 years to make sure that the patient voice is heard and listened to by policy makers.
  2. For further information please contact the Patients Association on 02084239111 or on comms@patients-association.com.
  3. To see more information on the Patients Association visit www.patients-association.com


Channel website: https://www.icaew.com

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