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Care of dying 'could improve'

05/12/2007

There is room for improvement in the care of patients dying in hospitals, a national audit has concluded.

Today's report says that the spiritual needs of dying patients and their carers are not being properly assessed by the majority of hospitals in England.

But the Marie Curie Palliative Care Institute in Liverpool (MCPCIL), which led the audit, says that standards of clinical care for individual patients who are dying remain high.

Fifty-six per cent of all deaths in England occur in hospitals, and the study states that high-quality personal and nursing care is "essential for the patient to maintain dignity in dying".

The audit, which compared the care of dying patients in hospitals against Department of Health standards, is the first of its kind in England.

Almost 2,700 patients from 118 hospitals were involved in the audit between September and November last year.

It found that inappropriate blood tests were discontinued in 87 per cent of cases but that for one in five patients the presence or absence of symptoms was not recorded during their last 24 hours.

In addition, just 34 per cent of patients had their spiritual needs assessed, while one out of five hospitals did not know the most important person to contact in case of a sudden deterioration in an individual's condition.

And only half of families were given the appropriate information about local and national procedures following the death of a loved one.

"Hospitals need to recognise that care of the dying is part of the core service they provide," said John Ellershaw, professor of palliative medicine at the University of Liverpool and the director of MCPCIL.

"Within the audit, some hospitals have demonstrated high standards of care.

"The challenge is to spread this best practice to all hospitals to enable patients to die with dignity and with appropriate support for their relatives."

Professor Mike Richards, chair of the end of life care strategy advisory board, commented: "How we care for the dying must surely be an indicator of how we care for all our sick and vulnerable patients.

"Care of the dying is urgent care; with only one opportunity to get it right to create a potential lasting memory for relatives and carers. The audit findings will help hospitals to recognise areas of high achievement and areas where improvements can be made."