Using health and care services at the end of life

Everyone needs care of some kind when they get to the end of their life. How do we ensure that care received in the months, weeks or days before people die is of good quality? 

This is a critical policy issue that should be pivotal to any understanding of a well-functioning health service, from a practical perspective as well as a moral one: health service use tends to be highest during this phase of life. Yet specialist end of life services are highly fragmented, and to a large degree delivered by the charitable sector through hospices. And there is a major lack of visibility regarding the care delivered by general NHS services – through GPs, community nurses and hospitals for example. This means there is a real lack of understanding at a national or local level of who is providing and who is receiving end of life care. To improve care quality, we really need a more detailed and comprehensive understanding of what care actually happens, and where.

This blog series picks up where previous Nuffield Trust work left off, looking at what has happened to end of life service use in the recovery period following the biggest waves of Covid-19. Each blog looks in turn at a different aspect of care: first, primary care services used by people who died at home and the impact of the increasing number and proportion of people dying at home since the start of the pandemic. Second, the health and care services that people who die in care homes are drawing on, and how this has changed. And third, how hospital services are used by people in the last month of life and opportunities to improve care.

Deepening our understanding is vital for ensuring that the right services are provided in a way that addresses the individual’s needs, and the needs of their family and those who care for them. These outputs contribute to a better understanding of end of life care services as a whole, and pave the way for further research we are conducting on variations and inequalities in the experience that different people may be having when accessing and using end of life care services.