Is London the worst place to die?

This was the topic of discussion at Tuesday’s meeting of the London Assembly’s Health Committee, which is carrying out an investigation into end of life care in England’s capital.

While the UK has been rated the best in the world for quality of death by the Economist Intelligence Unit, the available data tells us that in places – and perhaps, in London in particular – improvement is urgently needed.

There are examples of excellent care in London, but there are also high levels of variation. Health Committee members said they were ‘shocked’ by the findings of a recent report, co-produced by Marie Curie, London Cancer Alliance and PallE8, which show that specialist palliative care services aren’t available 9am-5pm, 7 days a week in 70% of London’s hospitals.

That means that a majority of London’s hospitals aren’t meeting the minimum end of life care quality standard recommended by the National Institute for Health and Care Excellence (NICE). It also means that people who need specialist care are likely to be missing out, simply because of which hospital they are in or where they live.

This is a problem which extends beyond hospitals, and beyond healthcare. A review by the National Council for Palliative Care found that, of the 36 local authorities that do not consider end of life strategies for their residents in their health and wellbeing strategies, 11 are in London. The committee is also particularly concerned about the care and support available to older Londoners who live by themselves and are less likely to be able to die in their place of choice.

What needs to be done?

What needs to be done to improve services so all people get the care they need? This will be one of the many questions that the Health Committee try to answer throughout their investigation.

From watching the evidence session on Tuesday, it is likely many of the answers will also apply to the rest of the UK:

  • Coordinated care that is of a high quality in all settings, including hospitals, care homes and in the community
  • Better public and professional understanding of palliative care

The committee will be accepting evidence until the 6 November and we will be contributing evidence and monitoring the investigation as it develops.

Action is needed

The issues coming out of the investigation are just as relevant to the rest of the UK as they are to London. Each year, 110,000 people across the UK miss out on the palliative care they need. That’s one in every five people who die. We cannot maintain a ‘business as usual’ approach in the face of these figures, and we need to remember the human cost behind the statistics.

The London Assembly and the House of Lords are now considering palliative and end of life care issues. We think it’s time for our representatives in the House of Commons, MPs, to recognise the importance of this issue and have a proper debate about palliative care. If you agree, please email your MP and ask them support a debate this November.