Palliative care access ‘inconsistent and often insufficient’, warn nurses

Access to specialist palliative care ‘remains inconsistent and often insufficient’, nurses have warned, as they argued for better investment in the nursing workforce.

Speakers at this year’s Royal College of Nursing (RCN) Congress have highlighted the need for everyone to be able to access end of life care, regardless of ‘background, diagnosis, age, or location’.

They stressed the need for sustainable funding, expanded 24/7 community care, and early identification of palliative care needs, as well as better investment in the palliative care nursing workforce.

Nurses voted at congress in Liverpool last week for the RCN Council to lobby UK governments to ensure everyone living across all four nations has access to specialist palliative and end of life care.

Proposing the resolution, vice chair of the RCN’s Pain and Palliative Care Forum Olajumoke Isaiah said investment in the nursing workforce is ‘not optional’.

She told congress that over the next 25 years, palliative care needs will rise by 23%, equating to an additional 40,000 people per year.

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However, she said that, without appropriate funding, by 2050 people will be ‘left without the support they deserve’.

‘Access to palliative and end-of-life care is not equal across the United Kingdom,’ she said.

‘As a care nurse, I’ve had the privilege of supporting patients and families at the most vulnerable moments of their lives.

‘I have witnessed what good palliative care can do, how effective symptom control [is at bringing] relief, and how honest conversations restore dignity… simply because the right care was there at the right time.

‘I’ve also seen the other side, patients referred too late, symptoms not controlled, individuals dying without the support needed or deserved.

‘Addressing physical, psychological, social, and spiritual needs should be accessible across all settings; homes, hospitals, care homes, nursing homes, and hospices.

‘However, access to specialist palliative care remains inconsistent and often insufficient.

‘Access is still determined by geography, privation, and diagnosis. Access to specialist palliative care is not a luxury, it is a right for every individual, regardless of background, diagnosis, age, or location.’

Ms Isaiah stressed that ‘investment is needing in the nursing workforce’, as well as ‘decisive government action, sustainable long-term funding for hospices and community services, expanded 24/7 community care, early identification of palliative care needs and services that are inclusive and cultural competent for all communities’.

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Nurses added that, with a lack of funding, hospices ‘are struggling’ and ‘relying on charity to survive’.

Cumbria nurse Rachael Ridley said: ‘This is not right. We have to do something about it. The government has to do something about it. They can find money to fight for animals, so why can’t you care for the people, the general population?’

West Midlands nurse Kevin Crimmons added: ‘I think it’s incredible in these days and times that a significant proportion of our health service still relies on charity.

‘When you rely on charity, you get inequity, because there are pockets of fantastic places and that’s not national.’

Nurses added that patients who struggle with accessing resources then seek legal assisted dying services abroad, with West Wales Nurse John Smith stating this was ‘unacceptable’.

‘If we can’t honour [their preferred place of care and death], then we are failing.’

This comes as The Terminally Ill Adults (End of Life) Bill, which would have allowed those who are terminally ill to request and be provided with assistance to end their own life, ran out of time in the House of Lords and will not become law.

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While it passed historic votes in the House of Commons, it failed to complete the legislative process before the end of the parliamentary session.

During the debate, RCN President Bejoy Sebastian spoke on behalf of former RCN president Roswyn Hakesley Brown, who is in a palliative care pathway after a diagnosis of thyroid cancer.

She concluded: ‘The process of dying is part of everyday life for all of us. While debates continue across the UK about assisted dying, it is vital that everyone has access to high-quality palliative and end of life care.’