Table of contents

Unmet needs and service gaps

Adults :: End of life :: Unmet needs and service gaps

• More training is required for the wider workforce on end-of-life care. Need to educate professionals to initiate end-of-life conversations and advance care planning.
• There is a need for a proactive identification of people approaching end-of-life, better coordination of care and communication between services.
• There is inequity in end-of-life care for non-cancer patients especially those with mental health problems e.g. dementia and patients with long-term conditions and learning disabilities.
• There is a gap in pre bereavement, only patients with complex needs receive the service.
• The majority of people in England would prefer to die at home, however lack of timely access to appropriate community services prevent more people dying in their place of choice. In Medway, nearly half of the deaths (48%) occur in hospital.
• There is no existing mechanism for identifying the needs, wishes and preferences for end-of-life care for people with dementia and learning disabilities.
• There is currently no systematic approach to capturing patients' views in the use of the service, although there is patient representation within the End-of-Life Care Group.
• The main barrier to the delivery of good quality end-of-life care is because people are not identified early enough to provide this care as they are approaching end-of-life.
• The projected increase in the ageing population in Medway, points to the future needs in developing skills in the community if admissions, especially emergency admissions, are to be avoided.
• Lack of information and data to inform decisions regarding the end-of-life care needs specific to BME groups, including spiritual and cultural needs.