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CQC's End of Life Thematic Review Report

The CQC's End of Life Thematic Review Report was created following the recommendation of “More care, less pathway, the independent review of the Liverpool Care Pathway”, The CQC looked at ‘how dying patients are treated across various settings’. In particular, they focused on end of life care for people who may be less likely to receive good care, whether because of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.

They spoke with people who may be less likely to receive good care - whether because of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances - to inform them about their experience of end of life care, and the barriers which may prevent them from experiencing good, personalised care at the end of life.

Findings

  • People from certain groups in society are experiencing poorer quality care at the end of their lives than others because providers and commissioners do not always understand or fully consider their specific needs.
  • Some commissioners and providers might not be fulfilling their duties under the Equality Act 2010 as all public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work.
  • Health and care staff are not always having conversations with people early enough about their end of life care. This means they don’t have the opportunity to make plans and choices with their loved-ones about how and where they would prefer to die.
  • CQC identified examples of good practice, but found that action is needed to make sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances

Recommendations

  1.      Leaders of local health and care systems to work together to develop a plan for delivering good quality, equitable end of life care for everyone in their community.
  2.      Commissioners and providers to fulfil their duties under the NHS Constitution, the Health and Social Care Act 2012 and the Equality Act 2010 to reduce inequalities, eliminate discrimination and advance equality when developing, arranging or delivering end of life care.
  3.      Commissioners and providers to ensure that staff who care for people who may be approaching the end of life, including care home staff, have the knowledge, skills and support they need.
  4.      Hospices to champion an equality-led approach, engage communities, deliver equitable end of life care, and support others to do the same.
  5.      GPs to ensure that everyone with a life limiting progressive condition has the opportunity to have early and ongoing conversations about end of life care, and is given a named care coordinator