NHS offers more help to die with dignity at home

The terminally ill will get more help to die at home rather than in hospital, ministers pledged yesterday.

The 'end of life strategy' aims to help the dying and their families to prepare for death and to encourage medical staff to ease the process. 

Health Secretary Alan Johnson promised teams of 'rapid response nurses' to be available at all times to provide care for the terminally ill in their homes. 

He also pledged more support for hospices and an extra £286million to fund Health Service care for the dying. 

About half a million people die in Britain every year, two-thirds of them aged over 75.

Just under 100,000 die at home annually, while around 300,000 die in hospital. 

Mr Johnson said yesterday that most would prefer to die at home. 'People coming to the end of their lives, and their loved ones, deserve high-quality, compassionate and dignified care on their own terms,' he added.

'This strategy will make that happen.
'We have already made £40million available to hospices to improve environments and provide greater dignity for patients. 

'Now this increased funding will continue momentum for improvement and make sure that everyone gets access to high quality palliative care and has choice about where that care takes place.' 

But the Conservatives criticised the scheme as too little, too late. Health spokesman Stephen O'Brien said: 'This twice-delayed strategy is an admission of ten years of Government neglect of end of life care and a missed opportunity to support the sector. 

'Helping people to have the choice to die at home, if they wish, is an important step, but the Government seems to have sidelined the wonderful contribution hospices make to end of life care. 

'Not only that, Gordon Brown has broken his promise of funding for the sector, meaning charitable giving is paying for NHS care.' 

Some doctors have raised concerns about the criteria for deciding when someone is about to die.

They fear some patients - especially dementia sufferers - are at risk of being prematurely put on the 'pathway' to dying.

London hospital consultant Adrian Treloar wrote in the British Medical Journal earlier this year that the system fails to 'ensure that only people who are about to die are allowed on to the pathway'. 

He said the approach relied on continuous deep sedation and patients who might take years to die were considered eligible for sedation or withdrawal of treatment.
Help the Aged welcomed the policy, but said it must lead to real improvements. 

Policy director Paul Cann said: 'For far too long, there has been a presumption that death should be at the convenience of the system, as opposed to respecting the individual wishes of those who are approaching their final days.

'This is an important step towards securing true dignity - a watchword which ministers are keen to repeat, but where we need to see concrete action among individual cases.

'One area which requires focus is in the management of pain. We continue to hear too many cases of older people left to face death without effective pain management.'