Access to Palliative Care Bill [HL]

Policy and legal background

2 According to the Office of National Statistics, 495,309 people died in England in 2015, a figure which it expects to increase with the population size and age.

3 Palliative care means care which is delivered to seek to improve the quality of life of persons with life-limiting illness or approaching the end of life, through the prevention and relief of suffering by means of early identification, assessment, treatment and management of pain and other problems whether physical, psychological, social or spiritual. Palliative care differs from curative strategies in focusing primarily on the consequences of a disease rather than its cause or specific cure. Palliative care is intended to complement oncological or other disease-focused treatments and not substitute for or replace them.

4 Research published in Palliative Care concludes that around three quarters of people will require some form of palliative care during their last illness. 1 Analysis published in BMC Medicine in May 2017 suggests that demand for palliative care across England and Wales will rise by 40% by 2040. 2

5 In February 2017, the Marie Curie charity and Nursing Standard published a report concluding that two thirds of nurses do not have time to offer a high level of care for dying people. 3 An analysis by Hospice UK, published in May 2016, identified that 27% of CCGs did not have a strategy to address end of life care in their area. 4

6 The Health and Social Care Act 2012 gives authority over the commissioning of palliative care in England to CCGs. They have a duty to commission health services (implicitly including palliative care) based on the assessed needs of their local population.

7 In Wales, the principle of seven-day working by clinical nurse specialists has been in place since the Palliative Care Planning Group Report (2008) 5 chaired by Viv Sugar was implemented.

8 By requiring a published assessment of need and criteria for need to be met, the Bill aims to provide transparency between different CCGs, facilitating the sharing of best practices and allowing variable outcomes to be analysed.

9 The Bill has been shortened compared to previous versions of this Bill. It now makes provision for individual CCGs to establish local strategies for palliative care, helping ensure local autonomy. This is in accordance with the principle of local autonomy established in the Health and Social Care Act 2012.