ONS report explores care quality received by bereaved families

One in 10 people suffering a bereavement rated the care their friend or relative had received in the last three months of their life as “poor”, according to newly-released data.

The Office for National Statistics (ONS) said if found four areas – London, Essex, Greater Manchester and Birmingham and the Black Country – were significantly lower than the national average for overall quality of care.

In contrast, four areas of England were significantly higher for quality of care: Devon, Cornwall and the Isles of Scilly; Cumbria, Northumberland, Tyne and Wear; Bath, Gloucestershire, Swindon and Wiltshire; and Wessex.

Other findings from the National Survey of Bereaved People included a “wide variability” in the proportion of people dying in their preferred place, with as few as 12% of cardiovascular patients and as many as 64% of cancer patients dying in their place of choice.

On average, women were significantly more likely to die in their preferred place than men.

The ONS said quality of care rated as “excellent” was highest for hospices (77%) but lowest for out-of-hours services (26%).

The overall quality of care question was rated on a five point scale from “outstanding” to “poor” and the ONS said there were no significant changes between results presented in the 2011 to 2012 survey and this 2012 to 2013 survey.

While 43% of people rated care as “outstanding or excellent”, 9.6% rated it as “poor” while 13.8% said it was “fair”.

The ONS said the areas where quality of care was significantly below average corresponded to places of high population density and further research would be useful in investigating a link between urban and rural areas and quality of care.

Care and support minister Norman Lamb said: “We know that thanks to the hard work of health and care staff and carers, many people already receive good end of life care.

“We are determined to improve further so everyone can receive the best care possible no matter where they live.

“Seventy per cent of clinical commissioning groups should soon be capable of using electronic records to share end of life care choices across the health and care system so people’s wishes can be respected.

“We know that where this happens, far more people experience good end of life care and, in particular, that people are able to die where they want to be, which is usually in their own home with loved ones.”

Adrienne Betteley, end of life care programme lead at Macmillan Cancer Support, said: “This new data shows there is still an unacceptable level of variation in terms of choice for people at the end of life across the country.

“Everybody at the end of life should have their preferences recorded and, more importantly, fulfilled. Choice should be integral to everybody’s end of life plans, and not something determined by the inaccessibility or absence of services to support people at home.

“We know that most people with cancer would prefer to die at home, and having access to free social care is crucial in enabling people to do so.

“More people dying at home will also mean less strain on expensive NHS beds.

“Ahead of the general election, we call on all political parties to commit to introducing free social care for people at the end of life.”

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