An increased number of GPs are speaking to elderly patients about end of life care, however time pressures are restricting this, research from Public Health England’s National End of Life Care Intelligence Network (NEoLCIN) showed.
The proportion of GPs reporting they had never initiated the conversation with a patient has decreased from more than a third (35%) in 2012, to a quarter (25%) in 2014, showing that now 75% of doctors are discussing end of life care with patients.
While most doctors believed it was their professional duty to initiate discussions, they felt limited by time pressures, the reluctance of family members to discuss death, the passive expectation that someone else would decide on behalf of the patient, and uncertainty about their decline.
Professor Bee Wee, NHS England’s national clinical director for End of Life Care, said: “There remains a challenge to ensure that the quality of care for people approaching the end of their lives, and those important to them, is as good as it can be, regardless of where this takes place.”
The report also found that home continues to be the preferred place of death for people in England, followed by hospices and care homes.
More patients are getting their preferences as the proportion of people dying at home or in care homes has increased from 35% in 2004 to 44% in 2013. The number of people dying in hospitals has dropped by 50,000 since 2004. In 2013 it was less than half of all deaths.
Professor Julia Verne, clinical lead at Public Health England’s National End of Life Care Intelligence Network, said: “It is of course appropriate for some patients to die in hospital but this year’s findings are encouraging as our understanding of what patients want continues to improve.
“There is still work to be done to ensure we keep focus, not just on the numbers but on people’s experience of dying. However we are now a step closer to balancing out the number of people using hospital and community care,” she said.
See the full report here