Palliative Care Crisis: statement from Cicely Saunders International
13th November 2024
Cicely Saunders International calls on friends and supporters to join us in raising awareness of the critical shortage and fragmented availability of palliative care across the UK, as well as the need for appropriately funded, universally accessible services to support people with serious illness and those important to them.
Critical Gaps in Access and Provision
Access to palliative care remains highly patchy across the UK, with marked disparities based on geography, socio-economic status, health condition and the times that services are available. Rural communities and economically deprived areas are especially affected by this inequity, and individuals with non-cancer diagnoses are sometimes excluded from palliative care services despite facing similar or even more severe symptoms than those with cancer.
For example:
In England and Wales, almost 600,000 people die each year. Many of these individuals experience complex symptoms and healthcare needs towards the end of life.
Palliative care, which can improve quality of life, would be beneficial for approximately 90% of those with life-limiting conditions. However, despite its proven benefits, many people who could benefit from palliative care do not receive it in a timely manner.
The number of people who do receive palliative care is not recorded in any government figures.
Only around 28,900 people die as an inpatient in hospices each year in England and Wales, around 5% of all deaths.
While around 60-80% of people express a preference to die at home, in many regions most are unable to do so due to a lack of accessible palliative care support.
A national study in 2022 found that only around 30% of UK areas offer out-of-hours palliative care telephone support, even though this has been a NICE recommendation since 2011. 27% of areas offer no designated support at night and at weekends, and around 40% of areas offer partial coverage out of hours.
There are many missed opportunities to improve frail older people’s recovery during hospital admission, and for proactive care in the community, which would improve quality of life and reduce emergency hospital attendance.
Despite their proven benefits, in the UK most hospices offering inpatient and community support are run by local charities, with only around a third of their funding coming from the NHS, with the remainder (over £1bn a year) raised by hospices themselves.
An over-reliance on charitable income means that hospice services are almost always better resourced in wealthier parts of the UK. Access to hospices services varies markedly across the UK.
People from ethnic minority groups can miss out on palliative care and may be adversely impacted by policy changes, for example, as was evident during the COVID-19 pandemic.
These gaps not only undermine patient choice and quality of life but also place additional strain on families and informal carers, who often assume caregiving responsibilities willingly, but with too little support or guidance. The fragmented access to palliative care also means that patients frequently face emergency admissions to manage symptoms that could have been addressed earlier through community-based palliative care.
You can download the full statement below.