Welcome New Proposals on Social Care for the Terminally Ill.

The Labour Party has proposed a new care system which would allow patients to focus on living their final months and weeks in their place of choice. Crucially, it is proposed that means-testing be scrapped (essentially allowing all patients with a terminal illness the option of being cared for in their preferred place of care). This would reduce stress and the burden of financial pressure on patients and their families associated with means-testing, allowing patients to make genuine choices.

This is a helpful shift in policy and complements the recent palliative care funding review which stressed the important of patient choice and care outside of the hospital setting.

However, an emphasis on more effective coordination of health and social care is also necessary – whether this is at the hospital discharge stage or when trying to ensure that the patient is never admitted to hospital. In theory this is going on already with tools such as a Preferred Priorities for Care being widely used – but these are reliant on strong integrated care and communication between health and social care professionals. Good coordination systems, as well as fair access to services is needed in order that a patient’s wishes for care be respected.

What remains crucial is that quality of care is high, regardless of the setting. Whilst steps must be taken to ensure that terminal patients can die in their preferred place of care, end-of-life care in hospitals must not be overlooked. The reality is that many of us will die in hospital due to the complex nature of our condition, families not being able to cope or lack of other places to die. Steps must be taken to make sure that patients who are hospitalised, either by choice or by necessity, can have as good a death as if they were cared for in a hospice or at home.

In other words, enabling more people to die at home is undoubtedly a good thing. But, our number one priority must be to ensure dying people are able to access high quality coordinated health and social care regardless of setting – so that wherever someone dies their death is as dignified as possible. Whilst steps must be taken to ensure that terminal patients can die in their preferred place of care, end-of-life care in hospitals must not be overlooked. The reality is that many of us will die in hospital. Steps must be taken to make sure that patients who are hospitalised, either by choice or by necessity, can have as good a death as if they were cared for in a hospice or at home.