A national review by the Care Quality Commission (CQC) has found that people from certain groups in society are experiencing poorer quality care at the end of their lives than others because providers and commissioners do not always understand or fully consider their specific needs.
In “A different ending: Addressing inequalities in end of life care”, published on Monday 9 May 2016, the CQC reports that only 67% of the 40 clinical commissioning groups (CCGs) it surveyed said that they had assessed the end of life care needs of their local populations – meaning that one in three had not.
Also, the CQC found that only 18% of the 40 CCGs had commissioned specific services for at least one of the population groups considered in its review – this includes people whose social circumstances make them vulnerable, older people, people with dementia, a learning disability, a mental health problem, or a chronic progressive illness other than cancer.
The impact of this could be that local health and care services are not fully equipped or ready to help these particular groups of people in their areas to get truly personalised care at the end of their lives.
This could lead to people’s wishes not being met or them not having the full range of options of where they would prefer to be cared for and die available to them. For example, an older person may be admitted to hospital in the last days of their life when they would prefer to die at home.
While in some areas commissioners and providers are taking an equality-led approach, the review findings raise concerns that some might not be fulfilling their duties under the Equality Act 2010, which states that all public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work.
In its national review, CQC is calling for action to make sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.