Marie Curie Policy & Public Affairs Presentation from the launch of Death and Dying: Understanding the Data - 14th February 2013

1. Follow us on Twitter: @mariecuriepa
#Deathanddying

2. The report
• Focuses on differences in provision, spending,
identification and experiences
• Identifies variations across different parts of the
country and a range of services
• Draws together & analyses data from the Marie
Curie End of Life Care Atlas & other sources

3. Our ambition
• To shift the debate about care for terminally ill and
dying people
• To use what we have learnt about end of life care
over the last year to improve care in all settings.
Now is the time to act

4. Why now?
• NHS reforms offer opportunity to re-prioritise and re-focus
services to emphasise development of better end of life care
• Ageing population and budgetary constraints mean increasing
pressures on already stretched NHS resources
• Stronger evidence base around end of life care. We have an
opportunity to use this increased knowledge to push forward
with improvements
• Francis report brings a renewed focus on patient needs

5. Changing demographics
• Total number of deaths per year to increase by 17%
• Particularly rapid increase in over 85s; Number of
deaths in those aged 85 years+ to increase by 48%
• People accumulate long term conditions as they age; by
65, most people have multiple conditions
• The more conditions people have, the more hospital
care they consume in the last 12 months of life

6. Growing evidence base
• Marie Curie End of Life Care Atlas
• VOICES survey of bereaved relatives
• Nuffield Trust study of the impact of the
Marie Curie Nursing Service on hospital use
• Nuffield Trust study of health and social
care at the end of life
• Whole system Delivering Choice
evaluations (Lincolnshire & Somerset)
• Recent polling by Marie Curie

7. Marie Curie End of Life Care Atlas
• Web-based mapping tool brings
together range of data on end of
life care across the UK
• Range of indicators, include
population characteristics, need
and identification, patient and
carer experience, costs, and
place of death

8. Death and dying – experiences (VOICES)

9. Death and dying – experiences (VOICES)

10. Death and dying - spending
Declared PCT spend on
specialist palliative care
per death varies from
£193 to £7,445

11. Death and dying - identification
Average of 26% of
deaths with
palliative care needs
on Palliative Care
Register; ranging
from 14% to 70%

12. Death and dying – deaths in hospital
Greater proportion
of people die in
hospital in urban
areas than rural
ones

13. Recommendations
• Better targeting of end of life care
• Improved training for doctors and nurses
• A standardised approach to reporting spending
on end of life care
• Outcomes based KPIs
• Free social care for those in the last six months of
life

14. Challenges & Opportunities
• Ageing population
• On-going constraints on public spending
• NHS reforms
• Francis

15. Moving the debate forward
• Over-reliance on hospital based care
• Evidence shows that people do not want to die in
hospital, do not need to be there & experience poorer
care if they end up there
• Evidence should give us confidence to shift away from
our current reliance on hospitals.

16. Moving the debate forward
• We must seize opportunity afforded us and ensure that people
at the end of life get the services they require; in the place of
their choice, being pain free and surrounded by the people they
love
• We have the evidence, what we need now is the determination
and the will to affect fundamental changes which will ensure
better quality care for dying people
•We are keen to work with you to improve end of life care
services in all settings and to move the debate on.

17. Follow us on Twitter: @mariecuriepa
#DeathandDying