Under a review of Palliative care ordered by the government it could see millions of pounds being saved in a new system for end-of-life care. The review proposes a fairer funding system, which will see a national payment structure being set up. This would cut the current variations around the country with greater clarity on what the state pays for and what is does not.
Currently the total spent by primary care trusts (PCTs) in England on palliative care varies radically dependent upon where the patient lives and this can range from £186 per patient to £6,123, furthermore, where the patient lives also affects the services they receive and this can include whether they receive round-the-clock care. Currently experts estimate that around 90,000 more people die in hospital than they wish to.
The Health Secretary, Andrew Lansley ordered a review of “Palliative Care Funding”, and this review proposed the implementation of a “fair and transparent” funding system where the money is linked to the needs of individual patients.
The scheme proposes that patients undergo an initial assessment of their needs; this in turn is then combined with other factors such as their age and capabilities. The proposed “needs classification system” would have 25 separate classes (13 for adults and 12 for children), each with its own funding, the funding would take into account various factors, including:
The government’s latest proposal would guarantee funding regardless of where patients live, whether they live in a care home, their own home or in hospital. Currently experts estimate that by 2021, this new palliative scheme will see a reduction in deaths in hospital by up to 60,000, this could save the NHS on average £180m annually.
Thomas Hughes-Hallett, chair of the review and chief executive of Marie Curie Cancer Care, said, “No other country in the world has introduced such a system for both adults and children, so the step is both a bold and necessary one.”
Professor Sir Alan Craft, adviser to the review, said, “The government must act on the recommendations contained in the review because evidence shows us that incentivising the provision of palliative care leads to better outcomes for patients, supports choice and is the most effective way of using NHS resources, we need to remove barriers within the current system to enable this to happen.”
Currently only 20% of patients die at home, which is 30% to 40% less than those patients wanting to die at home. “People want a choice over where to die” confirmed Ciaran Devane, chief executive of MacMillan Cancer Support, she went on to say “Twenty-four hour community nursing services are crucial to the delivery of choice and to the realisation of these ambitious recommendations.”
“It will be up to the government to ensure that these services are standard across the country. We need to see a massive improvement on the 56% of PCTs who currently provide 24-hour community nursing.”
Simon Chapman, director of policy and parliamentary affairs at the National Council for Palliative Care, said, “It is vital that the government acts of the review’s recommendations and creates a fair funding mechanism that will ensure people get high quality end of life care where and when they need it.”
“We only get one chance to get it right for dying people, which is why it must be a priority to ensure everyone who needs it can access palliative care around the clock.”
The government’s latest review and proposal to overhaul palliative care for patients will not only see the NHS save millions a year, which could be spent elsewhere such as on training and recruitment, but it will also see better end-of-life patient care.
This increase in palliative care will see the need to train and recruit more nurses to care for patients at home which can only be a good thing as more nurse and community nurse jobs should become available within the NHS.
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