Staff shortages and increased caseloads prevent effective pain management at home for dying people

Staff shortages and increased caseloads prevent effective pain management at home for dying people

May 13, 2017

Only around half of healthcare professionals who support dying people at home say staffing levels are sufficient to meet their pain management needs according to new research published today.


Fifty-one per cent of those surveyed said staffing levels were sufficient to meet needs, while more than a third (35 per cent) said they were not.


And many healthcare professionals supporting dying people are over-stretched with one in five of those surveyed (20 per cent) describing their caseload as “not manageable”.


Nearly a third (29 per cent) of respondents described the availability of end of life care training in their area as either “requiring improvement” or “inadequate”.


A quarter of those surveyed (25 per cent) said they had no access 24/7 telephone end of life care advice for people at the end of life, their families and carers.


The charities Hospice UK and the National Council for Palliative Care (NCPC) surveyed 370 healthcare professionals across England who work to support dying people at home. They included community nurse specialists, hospice service leads and GPs.


Many people want the choice to be able to stay at home at the end of their lives, which is supported by Government and NHS England policy. However, pain management for people approaching the end of life being cared for at home lags far behind that of other care settings, including hospice inpatient units, care homes and hospitals.


The joint report sets out new guidance for service providers and Clinical Commissioning Groups to help improve pain management for dying people at home. It reinforces existing policy guidelines on end of life care such as the NICE quality standard and the Ambitions for Palliative and End of Life Care framework.


Tracey Bleakley, Chief Executive of Hospice UK said:


“Inadequate pain management for dying people being cared for at home due to issues such as staff shortages is unacceptable. People approaching the end of life should not be forced to make a trade-off between staying at home, where they would prefer to be, or going into hospital for effective pain relief.


“We hope this research will serve as a wake-up call for commissioners and providers to take concerted action to tackle the underlying issues depriving dying people of effective pain management at home.”


Claire Henry, Chief Executive of the National Council for Palliative Care, said:


“We know both that people’s top priority for their end of life care is being pain free, and that most people would choose be at home when they die. So it’s essential to make sure people dying at home have round the clock access to effective pain relief.


“We need new approaches to achieve this, including giving training and support to carers so they can give injections if that’s wanted. Everyone has a right to good end of life care; this issue needs to be addressed promptly and successfully.”


The survey follows research published by Dying Matters last week which found that 39 per cent of people would be willing to give an injection after receiving some training, in order to relieve pain or ease symptoms in someone who was dying. This rises to 61 per cent if a doctor or nurse was on hand to supervise the first few times.



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