Macmillan Cancer Support reveals that two in three (65%) cancer patients in England who died in hospital, wanted to die at home1. This comes as a cross-party committee of MPs and Lords today strongly recommend that the Government introduce free social care for people at the end of life “at the earliest opportunity” to enable more people to die in the place of their choice2.
According to a national survey of bereaved relatives and carers, nine in ten (91%) cancer patients in England who died in hospital in 2011 actually said they wanted to die elsewhere3. This has potentially great cost implications for the NHS4. Macmillan argues that the NHS simply cannot afford to continue to treat people at the end of life in hospital against their wishes.
A new ICM poll of GPs, oncologists and cancer nurses found that the majority (86%) think providing free social care at the end of life to help more people die at home would save the NHS money through, for example, facilitating swifter discharge and reducing unplanned emergency admissions5.
Almost all (99%) health professionals think that cancer patients should be supported to die at home if they wish to do so, according to the new poll. However, the overwhelming majority (99%) say that a lack of appropriate services, and slow and complex needs assessments (97%) are key factors in people not receiving appropriate social care at the end of life.
Dorothy died in hospital from colon cancer in 2012 aged 48. Her husband Alex, 63 from Lancashire, says:
“Dorothy was in hospital for six weeks at the end of life and was admitted eight or nine times in that last year. During all this time no-one told her she was at the end of life or asked her about what she wanted. No-one offered us social care support. I believe it could have made a big difference because caring for someone can be so tiring and stressful; you never get to clock off. My biggest regret was not getting her home to die. I’m going to have to live with that for the rest of my life.”
Duleep Allirajah, Head of Policy at Macmillan Cancer Support, says:
“The current means-testing process people have to go through to access the social care they need in the last days and weeks of their lives is grossly unfair. We know that only a minority of cancer patients end up being able to die at home despite it being the dying wish of the majority.
“The Government needs to act upon today’s recommendation by the Joint Committee for the Draft Care and Support Bill and make social care free for people at the end of life. This would ease the pressure on our over-crowded hospital wards and give all of us an actual choice about where we spend our final weeks. It is both costly and morally wrong to continue to let cancer patients die in hospital against their wishes and at great distress to families and carers like Alex.”
Macmillan Cancer Support is urging the Government to make social care free for everyone in the last weeks of life before the end of this Parliament in 2015.
If you or your loved ones need information or support please call Macmillan on 0800 808 00 00 (Monday to Friday, 9am-8pm) or visit our website.
1 Office for National Statistics, Additional analysis from the National Bereavement Survey (VOICES) 2011. Place of death based on death certificates. Where cause of death was cancer; 59% of bereaved relatives responding to the survey stated that the deceased had named a preferred place of death. Of those expressing a preference, and who died in hospital; 64% had wanted to die at home, 11% had wanted to die in a hospice, 15% had wanted to die somewhere else, and 9% had wanted to die in hospital.
2 House of Commons and House of Lords Joint Committee on the Draft Care and Support Bill (2013) Draft Care and Support Bill report
3 Office for National Statistics, Additional analysis from the National Bereavement Survey (VOICES) 2011.
4 There is an estimated potential net saving of £958 per person who dies in the community rather than in hospital. National End of Life Care Programme & National End of Life Care Intelligence Network (2012): What do we know now that we didn’t know a year ago?
5 Macmillan Cancer Support/ICM online survey of 155 UK health professionals who treat people living with cancer (55 GPs, 50 oncologists and 50 cancer clinical nurse specialists). Fieldwork conducted September 2012. Survey results are unweighted. 86% said that providing free social care for people at the end of life, to enable them to die at home, would save the NHS money through for example, facilitating swifter discharge and reducing unplanned emergency admissions.
Source: Macmillan Cancer Support