Third of palliative care patients not on registers

QOF palliative care registers only include two-thirds of patients who should be offered end-of-life care, a report says.

Practice teams should create action plans to increase the number of people on palliative care registers and to improve early identification of people who may be in the final year of life, it explains.

The report, commissioned by the NHS National End of Life Care Programme, examined the end-of-life care provided by 15 PCTs and 509 practices in England. It also looked at data on the 4,487 deaths in these PCTs in February and March 2009.

It identified examples of best practice that should be adopted more widely, including localised collaboration between district nurses and practice teams.

The researchers found that around 27 per cent of people who died were included on practice palliative care registers.

However, when asked to examine data on other deaths, practices suggested that a further 15 per cent of deaths were predictable, even though these patients were not included on palliative care registers.

Shrewsbury GP Dr Teresa Griffin, who has an interest in palliative care, said that including people on palliative care registers meant that their treatment could be planned, rather than being centred on crisis management.

'It's about helping people live better and providing a better quality of life at the end of people's lives,' she said.

She said that practice teams could use disease-specific clinics to examine patients for suitability for inclusion on palliative care registers.

Patients could then be assessed for conditions such as depression and any necessary treatments introduced, she said.

The report suggested commissioners should examine practice training needs 'particularly regarding the identification of people nearing the end of life, training in advance care planning discussions and support for people and carers at all stages'.

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