Commissioning of specialist palliative care services in England

Abstract

Objectives Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. Methods We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services.

End-of-life care means exactly what it says: palliative care is about care at the end of life, not about ending life

“…1,2 There are challenges, however, including improving access to specialist palliative care across geographical and disease boundaries. 3 Resolving these and other practical issues will become increasingly important as more of us live with long-term conditions. But the science and the structures are there.…”

Children’s unmet palliative care needs: a scoping review of parents’ perspectives

“…The literature also indicates that access to CPC services is an issue,10 with poor accessibility and availability of services having been evidenced to be a barrier to an individual’s needs being met. The current situations of the nursing workforce (including unfilled nursing posts), funding restrictions and consequential availability of services all influence the level of support children and their families receive when facing life-limiting and life-threatening conditions 11 12…”

“…It is well evidenced that parents, being legal guardians of the child, have a significant role in providing their child’s physical, ethical and social care needs, with a particular importance in caregiving and decision-making 12. The family also have a considerable responsibility for making sure the child receives ongoing and complex care 13.…”

What is the cost of palliative care in the UK? A systematic review

“…As a result, there are large variations in the levels of state funding provided, geographically as well as between services 2. A recent study by Lancaster et al 3 on the commissioning of palliative care services in England collected data from 29 Clinical Commissioning Groups (CCG) on the budget they allocated to palliative care. They found a wide variation in the budget allocation, ranging from £51.83 to £2329.19 per patient per annum 3.…”

“…A recent study by Lancaster et al 3 on the commissioning of palliative care services in England collected data from 29 Clinical Commissioning Groups (CCG) on the budget they allocated to palliative care. They found a wide variation in the budget allocation, ranging from £51.83 to £2329.19 per patient per annum 3. They also found limited correlation between the palliative care needs of the population and the budget allocated to palliative care services, supporting concerns about a ‘postcode lottery’.…”