Fast-track access to social care will have huge implications for people at the end of their lives

by Scott Sinclair
Policy and Public Affairs Manager

An amendment to the Care Bill introduced Scott Sinclair, Policy and Public Affairs Manager



by Lord Howe, which was debated in the House of Lords yesterday will, if accepted, have major implications for the social care of thousands, who are at the end of their lives.

The highly positive step will give local authorities the power to fast-track access to social care for those who are terminally ill.

This has huge implications as having access to social care can, in many cases, be the determining factor in whether someone who is terminally ill  is able to die in their place of choice (which for most people is at home or in a hospice), or whether they die in hospital.

Marie Curie has long been campaigning for this change, because we know that social care is hugely important to terminally ill people and their families. When people have timely access to social care, they are less likely to suffer emergency admissions and die in hospital.

Sadly, in the current system, terminally ill people can wait weeks or even longer to receive social care, which causes considerable emotional distress for patients and their families during an already difficult time. These delays play a huge role in why more than 50% of us die in hospital when the majority of people prefer to die at home.

A study by The Nuffield Trust, looking at 73,000 people in the last 12 months of life, found that those with access to local authority-funded social care were much less likely to use hospital care. In Torbay, where health and social care services are integrated, making it easier to access social care, the percentage of people dying in hospital is the lowest in England, despite the area also having the highest death rate in the country.

The problem is that the social care system as a whole moves far too slowly for terminally ill people. The care you receive can depend on where you live. Our patients and their families often tell us stories of them waiting weeks for local authorities to make decisions about a terminally ill person’s eligibility for care. We know of cases where people have waited for longer than a month and even, in one  case, of a relative receiving a decision from the local authority about their loved ones care after they had died.

There are examples of good practice - some local authorities already operate a fast-track system where they make sure that people with urgent need get swift access to care. Unfortunately these are often the exception, rather than the norm.

Marie Curie has been campaigning, along with Help the Hospices, to see fast-track access to social care for the terminally ill introduced for over a year now. Ultimately, we want to see it being made mandatory for local authorities to provide free social care to people in the last six months of life, rather than them simply being directed. This would help remove all the barriers that terminally ill people and their families encounter when they try to access social care.

In the meantime, this very welcome amendment will help thousands to spend their last months and weeks in comfortable surroundings with the people they love.