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Promise to improve care for dying Promise to improve care for dying
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People are to be given more choice over where they die as part of a package of measures to improve care for the dying.People are to be given more choice over where they die as part of a package of measures to improve care for the dying.
Ministers are to outline the plans for England's first End of Life Care strategy, backed by £286m over three years. Ministers said the key to this will be the creation of rapid response nursing teams to help carers.
One of the key steps will be a roll out of rapid response nursing teams to help those caring for people at home. But England's first End of Life Care strategy also calls for more openness in talking about and planning for death.
Extra money is being provided, but experts said it was still a challenge to turn "fine words into action".
Campaigners have long been calling for more focus on what they see as a neglected area of the NHS.Campaigners have long been calling for more focus on what they see as a neglected area of the NHS.
This has been a relatively low priority, and as a result the quality of care has been variable Alan JohnsonHealth Secretary 'My husband could die at home' For far too long, there has been a presumption that death should be at the convenience of the system Paul Cann, of Help the Aged 'My husband could die at home'
About 500,000 people a year die in England mostly following a period of chronic illness such as heart disease, cancer or dementia.About 500,000 people a year die in England mostly following a period of chronic illness such as heart disease, cancer or dementia.
Just one in five deaths happen at home despite two thirds of people saying that is where they would prefer to die.Just one in five deaths happen at home despite two thirds of people saying that is where they would prefer to die.
By comparison, 58% of people die in hospital with many families complaining of a lack of support and pain management leaves them with no other alternative.By comparison, 58% of people die in hospital with many families complaining of a lack of support and pain management leaves them with no other alternative.
The government's strategy is expected to set out how 24-hour on call nursing teams will rectify this by offering carers support in crises. The government aims to tackle this by setting up 24-hour on-call nurse teams across the country to help those caring for the dying at home to cope in times of crisis.
The aim is to increase the number of people who can opt to die at home or in a hospice, rather than in hospital. It is being largely modelled on a programme run by Marie Curie Cancer Care in six areas, which has doubled the number of people dying at home by offering support especially in the final weeks and days of life.
Pioneering pilots Training
It is being largely modelled on the Delivering Choice programme run by Marie Curie Cancer Care in six pilot areas. Ministers also want to see training offered to health and social care professionals to help them assess the needs of families facing a death.
The project has helped double the number of people dying at home by offering support especially in the final weeks and days of life. An extra £286m is being invested by 2011 to fulfil Labour's 2005 manifesto commitment to double funding in palliative care.
FROM THE TODAY PROGRAMME class="" href="http://news.bbc.co.uk/today/hi/default.stm">More from Today programme A specialist nurse on the range of end of life care that can be offered
But ministers are also hoping to promote a debate about the taboo of talking about death and planning how and where we would like to die. But this will happen over a period when the NHS budget will have increased by nearly 50% anyway.
Health Secretary Alan Johnson will say that how we care for the dying is the "hallmark" of how we care for all sick and vulnerable people. And the focus on palliative care ignores the general resources spent on looking after the dying, which suggest the extra £286m is not as large an increase as first seems.
He told the BBC it was important to try to allow people their personal perference wherever possible. For example, over £1bn a year is spent on district and community nursing. About 40% of their time is spent looking after the dying.
Mr Johnson said: "This has been a relatively low priority, and as a result the quality of care has been variable. But Health Secretary Alan Johnson dismissed suggestions there was not enough money to achieve the aims, pointing out it was also about changing the way the system worked.
"We need to ensure this is a priority across the country." "People coming to the end of their lives and their loved ones deserve high quality, compassionate and dignified care on their own terms.
The new strategy comes after criticisms from campaigners. "This strategy will help it happen."
A cross parliamentary group of MPs called Dying Well said there were serious inequalities in the provision of services in a report they produced in 2006. He also said he wanted to start a national debate to get people talking about death.
Hospices have also been vocal about the lack of funding they say they receive. The strategy suggested a number of ways to encourage that, including getting funeral directors to hold open days and schools to start discussing it with pupils.
Scotland is also working on its own plans for end of life care, although families often report it is easier to access services because of the system of free personal care - it is means-tested elsewhere in the UK. Paul Cann, from Help the Aged, said: "For far too long, there has been a presumption that death should be at the convenience of the system, as opposed to respecting the individual wishes of those who are approaching their final days."
But he added the challenge now was to turn "fine words into action".
And shadow health minister Stephen O¿Brien said the government had ignored the "wonderful contribution" made by hospices.
England's strategy comes as Scotland is also working on its plans for end of life care.
Meanwhile, Wales has already produced guidance on the issue, but it is too early to tell if it has had a significant impact.Meanwhile, Wales has already produced guidance on the issue, but it is too early to tell if it has had a significant impact.
What do you think of these measures? Would you prefer to plan where you die? Send us your comments and experiences using the form below.What do you think of these measures? Would you prefer to plan where you die? Send us your comments and experiences using the form below.
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