Charity calls for improved training in palliative care

In a new report, ‘Triggers for Palliative Care’, the charity shows there is limited understanding of what palliative care can do, who it benefits and when to introduce it. It reveals that professionals do not receive enough training in the area and often miss the opportunity to consider whether there is a palliative care need.

Palliative care focuses on providing individuals with relief from pain and other debilitating symptoms and the stress associated with advanced progressive illnesses. The goal is to improve quality of life for both the patient and the family, and includes psychological, social and spiritual support. It can begin at any stage of an illness and can be provided alongside other curative therapies.

The report, which includes a foreword from the leaders of the Association for Palliative Medicine of GB and Ireland, Royal College of General Practitioners, Royal College of Nursing and Royal College of Physicians, highlights the different signs that help to identify when someone needs palliative care, particularly people with conditions such as heart failure, chronic obstructive pulmonary disease, dementia, end stage liver disease, motor neurone disease and conditions such as multiple sclerosis, Parkinson’s disease and stroke.

These people are currently less likely to receive palliative care than people with terminal cancer because their illnesses tend to be more unpredictable in their progression than cancer, which tends to involve a recognisable decline.

Dr Jane Collins, Chief Executive of Marie Curie, said: “Each year around 110,000 people in the UK don’t get the palliative care that they need. Many people who could benefit from palliative care earlier in their illness miss out because doctors, patients and their families do not realise when it is needed and incorrectly assume it is only for people who are in the final weeks or days of their lives.”

“Palliative care can benefit people with many different illnesses and at different times in those illnesses. Healthcare professionals simply don’t receive enough training to be able to recognise when someone needs palliative care or when someone is dying. Today’s findings and the recent Parliamentary Health Service Ombudsman report demonstrate that we need to change this.”

The need for more training is reinforced by the findings of a Marie Curie-commissioned survey of 500 UK clinical professionals in which over a third (39%) say that a lack of relevant experience amongst staff delivering care is a barrier to meeting the needs of terminally ill people[2] and over half (55%) consider better identification of an illness as terminal to be highly important in improving the quality of patient care[3].

To coincide with the report, Marie Curie has written to NHS medical and nursing directors around the UK, urging them to improve access to palliative care for everyone (both people with cancer and non-cancer conditions) in the hospitals that they run. This includes, ensuring that all staff know how to access palliative care teams and that staff, patients and their families are provided with enough information. Marie Curie is also campaigning for mandatory undergraduate and continuing professional development training for health and social care professionals in providing care to people who are dying.

Professor Rob George, President, Association for Palliative Medicine of GB & Ireland, said: “Adequate and expert care of people as they seek to live with life-limiting illness must be a priority in any civil society.  Yet this important report joins a series of publications over recent months showing this not to be the case generally. Too often the person gets lost in medicine’s preoccupation with treating their disease. It is not that we don’t have the models and approaches to care, it’s that the conversations are not joined up, and not just at the bedside, but between those needing care and those commissioning and providing it to design and deliver services and support that makes sense at that bedside. This report gives much needed factual contexts for such conversations across our society and health economy. As specialists on the front line, the Association for Palliative Medicine welcomes this whole-heartedly.”