End-of-Life Care Needs Urgent Improvement, Doctors Warn

The Need for a National Strategy on End-of-Life Care

Healthcare professionals are urging the development of a public campaign and a national strategy focused on end-of-life care. This call comes as concerns grow over how this critical phase of life is often treated as an unexpected or last-minute crisis, even when individuals are already in hospitals or other care settings.

The Royal College of Physicians (RCP) has highlighted that current healthcare systems prioritize treatments aimed at curing patients, despite many individuals suffering from progressive, life-limiting conditions. They emphasize the need for a cultural shift in both healthcare and society to better support palliative and end-of-life care.

Dr. Hilary Williams, clinical vice president of the RCP, described anticipating the end of someone’s life as “an act of clinical courage and kindness.” According to previous research, approximately 70% of people die from long-term health conditions that follow a predictable course. Despite this, many patients and families feel unprepared for the end of life. Open, supportive conversations can help patients recognize their situation and may lead to changes in treatment and support strategies.

The RCP has outlined several key recommendations, including the development of a public campaign on end-of-life and palliative care, support for professional education and training, and the commissioning of a national strategy that includes staff training. They also pointed out significant barriers, such as challenges in social care and the imbalance of funding and workforce in healthcare.

Dr. Williams stressed that real change will only happen when continuity of care is valued, experienced decision-makers are involved, and clinicians have the time to engage in honest conversations with patients and families about what lies ahead. She emphasized that these are complex decisions rooted in expertise and experience, which the system must learn to value.

Supporting the RCP’s calls, Dr. Nick Murch, president of the Society for Acute Medicine, noted that the end-of-life phase is often seen as unexpected or a last-minute crisis. He added that with the right support and planning, more people could die in comfort, in a place of their choosing, and with dignity.

Dr. Suzanne Kite, president of the Association for Palliative Medicine, called for a national strategy to ensure everyone has access to high-quality palliative care, wherever they are, as early as necessary. She emphasized the importance of embedding opportunities for honest conversations about the final months and weeks of life into care, along with systems, training, and public discussions that support this.

Palliative care and bereavement charity Sue Ryder backed the RCP’s call, stating that while end-of-life care makes a positive difference, palliative care providers could be helping people live as well as possible for as long as possible. They pointed out that around 8% of people referred to hospices die before they can be admitted, suggesting referrals are made too late. Healthcare professionals should consider palliative care benefits from the moment a terminal diagnosis is received, not just in the final days of life.

A Department of Health and Social Care spokesperson stated that the government aims to create a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. Part of their 10-Year Health Plan involves shifting more healthcare out of hospitals and into the community, with palliative care playing a significant role. The government has invested £100 million in hospices to improve care.

The RCP clarified that its position on end-of-life care is separate from its stance on the assisted dying Bill. The college has previously raised concerns about aspects of the Terminally Ill Adults (End of Life) Bill, including safeguards for vulnerable patients, equitable access to care, clinical responsibilities, and the need for multidisciplinary teams to make complex decisions. These issues require further consideration, and the college urged peers in the Lords to address them to ensure robust protections for both patients and healthcare professionals.