End of life care
End of life care aims to improve the quality of the life of the patients and families facing problems associated with life-threatening illness.
There are around 1,000 deaths each year in Tower Hamlets, with a lower proportion of deaths in older people compared to the national average, reflecting the young age profile of the population. The main causes of death are cancer, circulatory and respiratory diseases.
In Tower Hamlets the term “last years of life” has been adopted to describe the period before death, recognising that this time may be days, weeks, months and even years for different people. Using this terminology helps health and social care service providers to respond early to the care needs of patients and their families, when they are better able to express their preferences about the type and place of care and death, and when care can be tailored to their changing needs.
Because most people say they would prefer to die at home, increasing the proportion of deaths in people’s “usual place of residence” is used as a measure of how well people are able to make choices about their care. Although similar numbers of people die at home in Tower Hamlets compared to the national average (around 23%), significantly more Tower Hamlets deaths occur in hospital (59%) compared to the national average of 47%. Far fewer deaths occur in care homes (7% compared to the national average of 22%) and more in a hospice (10% compared to 6% nationally).
When asked about their experiences with a relative during their last months of life, bereaved carers in East London (including Tower Hamlets) are less likely to rate care received as high quality, compared to England averages.
Work we are doing locally to tackle this issue
Our integrated care programme includes a range of interventions which aim to
- provide person-centred integrated care
- identify and meet palliative needs early and in accordance with people’s preferences
- improve the quality of care, and monitoring this through to the views of residents and their families
- improve the experience of hospital care in last years of life
- provide specialist palliative care
- provide specialist training and education for health and social care staff
- reduce inequalities in access and experience between population groups and between groups of people with different health conditions
- increase community approaches to last years of life
To achieve these aims, the integrated care programme has put in place multi-disciplinary training in palliative care for health and social care staff, care planning and navigation, shared records, crisis planning and rapid access to care.
You can find out more about care in the Last Years of Life in Tower Hamlets in the Joint Strategic Needs Assessment
You can talk to your own GP, practice nurse or social worker about any aspect of care in the last years of life, or after someone has died.
Useful external links
NHS Choices: www.nhs.uk/Planners/end-of-life-care
Macmillan Cancer Support: www.macmillan.org.uk/HowWeCanHelp/Nurses
Marie Curie: https://www.mariecurie.org.uk/
Dying Matters: www.dyingmatters.org