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Macmillan highlights pain relief failings in end of life cancer care

People who receive poor pain relief at home are less likely to die where they want to, charity says

People with cancer who receive poor pain relief at home are less likely to die where they want to, compared with those who receive complete pain relief, according to a national charity. 

Analysis by Macmillan Cancer Support of the Voices National Survey of Bereaved People 2014 found that almost half (49%) of people with cancer who received only partial or no pain relief at home did not die where they wanted.

In comparison, the survey of 2,962 relatives and carers showed that only 23% of those who received complete pain relief at home, some or all of the time, did not die in their preferred place. 

Macmillan is concerned that a lack of support at home, including pain relief, is limiting choice for people at the end of life regarding where they are cared for. It says many are ‘spending their final days in oversubscribed hospital beds against their wishes’. 

The charity wants the government to fund improvements recommended in the Choice in End of Life Care programme board’s independent review, published last year. 

These include that a person’s preferences be recorded in an individual care plan and that they have a care co-ordinator as their first point of contact. 

By the end of 2019, there should be 24/7 end of life care for people being cared for outside of hospitals, the programme board said.

Macmillan chief executive Lynda Thomas said: ‘Quite simply, in the 21st century people should not be spending their final hours in pain in this country because the support is not there. 

‘It is tragic for the individual and distressing for family and friends who witness their loved one in pain.’

An NHS England spokesperson said that the Voices survey had shown that three quarters of bereaved people rate the overall quality of end of life care for their relative as good or better.

'However, we know that there are variations in the care and services that people receive and we want to continue improving people’s experience of care, including relieving symptoms such as pain,' he added.

'This is why the NHS locally is working hard to build on the strong foundations that have made the UK internationally recognised as leading the world in end of life care.'

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