Today, the Parliamentary and Health Service Ombudsman published a report highlighting widespread failings in how healthcare professionals communicate with patients, families and carers, as well as other healthcare teams, when people are reaching the end of life. It finds that poor and unclear communication is failing patients, with many not being told early or clearly enough that they are approaching the end of life.
While the BGS welcomes the report’s recommendations to improve communication at the end of life, it represents another missed opportunity to highlight the needs of older people. Most deaths in the UK (70%) are among people aged over 75, and the majority of this group will die with multiple health conditions, including frailty and dementia. Despite this, the report does not adequately focus on the specific communications that affect older people at the end of life. Only 48% of people dying over the age of 75 are recognised as being at the end of life in their last month of life. Frailty severity is a strong predictor of mortality, but it is frequently overlooked as a trigger for earlier identification and conversations about end-of-life care. As a result, many older people are only told they are dying in the days before death.
The Modern Service Framework for Palliative and End of Life Care is a key opportunity to improve communication at the end of life. To achieve this, all older people with severe frailty should be identified as approaching the end of life and supported through early, honest conversations with them and those important to them. The BGS will continue to push for older people to be adequately represented in end-of-life care policy and stands ready to work with the Government to make this a reality. Read the report here.
