Too many care providers ‘flying blind’ about end of life care workforce

A lack of data about palliative care staff could lead staff shortages in the next few years, a new report from the National Council for Palliative Care (NCPC) has said.

The ‘Staff prepared to care? Capacity and competence in the end of life care workforce’ report found a lack of data about staff working in palliative and end of life care, making it hard to know if there will be enough staff to meet the rising need for end of life care. Based on the data it did gather, 44% of senior palliative care nurses were aged over 50 in 2013, and this percentage has risen in each of the last five surveys.

The NCPC report makes a number of recommendations:

• That national data collections for palliative care collect workforce data as well as patient data, and that individual organizations providing palliative care consider internal analysis of their workforce through various methodologies such as time and motion studies and/or comparison with other similar services.
• That specialist palliative care provider organizations examine their own staffing to assess whether they are likely to experience a staffing crisis within the next 10 to 15 years, and that Health Education England factor in a potential workforce gap into future workforce planning.
• That all localities, particularly those trialling new approaches to end of life care, focus on workforce planning with an emphasis on understanding the location of the workforce and the necessary skills for providing care in different settings.
• That staff who are not specialized in the provision of palliative care receive regular training to enable them to deliver high quality care to people at the end of their lives. Organizations who employ staff who work with dying people should ensure their staff are given opportunity to undertake such training.
• That social care be appropriately valued for the important part it plays in allowing people to die in their place of usual residence, and that initiatives continue to be put in place to enable health and social care services to work in a coordinated way.
  
• The NCPC is concerned that data about the palliative care workforce is not being gathered in enough detail by health care providers to plan for future staff needs. The number of people needing end of life care is expected to rise over the next 15 years, while many senior palliative care nurses will reach retirement age in the same period. But changing patterns of end of life care, with increasing numbers of people wishing to be care for at home at the end of their lives, will need a wider range of specialisms to be trained in end of life care.                                       

Claire Henry, Chief Executive of the NCPC, said: “The end of life care sector as a whole is flying blind when it comes to understanding its own workforce. Although many individual care providers know what they need to about their own staff, there’s a worrying lack of overall data. Even worse, the data we do have paints a worrying picture, with many senior palliative care nurses due to retire in the next five to 10 years.

“If we don’t get the data we require, then the whole end of life care sector risks being caught short-handed over the next few years. If we are all to receive the end of life care we need, we will need more specialist palliative care staff, but currently palliative care nurses are only measured as ‘adult nursing’ for the their training or ‘acute, elderly and general’ for their work. At the same time, end of life care increasingly needs multidisciplinary teams, including psychologists, physiotherapists, occupational therapists, chaplains and others. We need these staff to be skilled in supporting end of life care, but again we lack the detailed data to know if we have what we need.”
 
“If we don’t act now, we will face serious shortages at a time of increasing demand for good quality need of life care. None of us want to see our loved ones suffer needlessly at the end of their lives. We know the different good quality palliative care makes both to dying people and to their families. We can’t afford to be caught out in this area. But we can’t train, employ and support staff if we don’t know more about the workforce.” 

A copy of the full report can be downloaded here.