Ways and Means

Death comes to us all, but this truism doesn’t make it any easier to talk about. In health and social care, the understandable sensitivity around dying means that there are too few conversations between professionals and patients about patients’ preferences, making it difficult to plan or support people who are nearing the end of their life. Instead, many receive care of varying quality, often characterised by delays, a lack of information and an insufficient say in their end of life ‘journey’.

This report highlights several factors that contribute to these kinds of inequalities at the end of life. It reveals that the likelihood of what can be described as a ‘good death’ – one where the wishes of the patient and their family are met – can be significantly affected by where people live, their ethnicity and previous contact with social care. But the most critical factor is early diagnosis and timely initiation of support.

Ways and Means argues that tackling these inequalities requires placing an emphasis on training, communication and integration across health and social care. It recommends free social care at end of life be adopted as soon as possible, while ensuring that health and care professionals, who have a central role in providing well coordinated end of life care, are equipped and properly supported to talk about death. It concludes that a misplaced sense of delicacy must not prevent us from responding to people’s needs.