There is an ‘insufficient’ district and community nursing workforce to meet current or future end-of-life care needs, a charity has warned.
A new report from Marie Curie has suggested many nurses ‘do not have the time to provide the care they know their patients need’ because the workforce and wider services are ‘overstretched’.
Based on the findings of a nationally representative survey of 1,179 people affected by dying, death and bereavement in England and Wales, the report revealed that many respondents ‘felt support from their GP and other community-based services was inadequate’.
Only around half of survey respondents said that healthcare professionals provided them and the person who died with ‘as much help as was needed’ in the final three months of life.
Findings showed that more than a third (36%) of respondents did not have contact with a district or community nurse in the last three months of life, and even less (19%) had contact with a GP.
Related Article: New qualification aims to help care leaders harness cutting-edge technology
Respondents also flagged the difficulty in securing community nursing visits.
One said that ‘community nurses did their best but had constraints’, while another described ‘access to any services as almost an impossibility’.
Palliative care teams and community nurses were the highest rated professionals for providing the care needed by survey respondents, with over half (52.9%) of respondents saying they received ‘as much help as they needed’ from community nursing teams.
In contrast, GPs were the lowest rated professionals by respondents, with just over one in five (20.4%) saying that GPs did not provide ‘sufficient help’ in the final stages of life.
Ruth Driscoll, Marie Curie associate director policy and public affairs England, told Nursing in Practice: ‘District nurses and community nursing teams play a crucial role alongside hospice care at home in providing end of life care in the community.
‘This includes the emotional aspects of care and support, monitoring symptoms, prescribing and administering medications and “hands-on” practical care such as changing dressings and catheters. Workforce pressures, however, limit the care they can provide and its availability.’
She said the charity’s latest report painted a ‘bleak picture of health workers in local communities not having enough time to provide the care that dying people need, or not being available to them long enough or frequently enough’.
‘Given the crucial role district and community nurses play in the care of people approaching end of life, our new report gives us cause for concern that there is an insufficient district and community nurse workforce to meet current, let alone future demand for care,’ added Ms Driscoll.
Related Article: Welsh hospices given funding to deliver ‘fair salary’ for staff
‘Without urgent action, the quality of care for dying patients and their families in local communities is likely to become worse over time, as demand for end-of-life care increases due to our ageing population.’
Professor Katherine Sleeman, lead researcher on the project, said the study reveals ‘patchy and inconsistent’ end-of-life care provision.
And despite ‘examples of excellent care’ the overall picture was of ‘overstretched’ services, she said, with health and care staff ‘lacking the time they need to consistently provide high-quality care’.
She warned that by 2048 there will be a 25% increase in the number of people in the UK who need palliative care before they die.
‘Without a corresponding increase in capacity of primary and community care teams to support these people as they approach the end of life, the quality of care is likely to further suffer,’ added Professor Sleeman.
Related Article: Dr Crystal Oldman reflects on decade as head of ‘trailblazing’ QICN
‘It has never been more important to ensure high-quality palliative care for all who need it.’
Matthew Reed, chief executive of Marie Curie, said: ‘We are shocked to see this clear evidence of dying people struggling with pain and other symptoms because they cannot access the end of life care they need from overstretched GPs, district nurses and other health workers.
‘There are no two ways about it, care for dying people is in crisis.’
