Barnet has a population of around 2,400 people who die each year, with most preferring to die at home but still passing away in hospitals. When end of life care is unavailable in the community, patients are more likely to be admitted to hospitals, with 11% of emergency admissions and 21% of bed days due to patients in their last year of life. While some progress has been made, only 16% of Barnet deaths occurred at home compared to the national average of 19%. Palliative care services in Barnet provide high quality care but are fragmented and uncoordinated between different providers. Feedback confirms the experience can be inconsistent and rely on patients advocating for themselves.
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Pallative Care
1. Palliative Care
In 2007/08, there were 2,417 people who died in Barnet, which is just under
1% of the population. Research commissioned by Marie Curie Cancer Care
has shown that most people would like to be cared for, and die, at home if
they had a terminal illness. Unfortunately most people still die in hospital
(59%).
When patients do not have access to end of life care in the community, they
are more likely to be admitted to hospital. Research for 2006/07 indicated that
11% of all emergency admissions and 21% of all emergency bed days were
due to patient admissions in their last year of life. In Barnet during 2006/07,
16% of deaths were reported to have been at the patients home - an
improvement on the previous two years, but some way below the national
average of 19%. Nevertheless there was a variation in the place of death by
primary cause of death. For example, cancer patients in Barnet have a
greater chance of dying at home or in a hospice compared to patients with
circulatory and respiratory problems..1
Barnet does provide end of life care services that provide a high standard of
care. However, whilst individual services are of a high calibre, there is a
fragmented provision across Barnet which lacks co-ordination. Shadowing of
district nurses on visits to patients homes, and feedback from patients and
carers through a focus group and one-to-one discussions, confirms that the
experience of end of life care can be very fragmented and can rely on the
assertiveness and coordination skills of patients and their carers.
Key Message
Barnet citizens to experience a dignified death, in the place they choose,
including their home.
Patients diagnosed with chronic conditions, not related to cancer, such as
respiratory diseases are less likely to receive palliative care. This is
because the terminal phase is difficult to identify.
Provision of palliative services in Barnet can be fragmented and lack
coordination. The palliative care service needs to be improved.
1
During 2006/07, 22% of deaths in Barnet were people who were diagnosed with cancer and
received palliative care. This compares to 77% of people diagnosed with respiratory disease
who died in hospital and did not receive palliative care.