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Around 3 in 10 people with urgent palliative care needs are not being assessed on time

Macmillan Wales welcomes a report on the progress being made to improve end of life care but warns that 3 in 10 people referred for urgent palliative care between 2016 and 2017 were not seen on time. 


The Welsh Government’s report charts progress against the key commitments made in its End of Life Care Delivery Plan, which was refreshed in March last year.


While the report reveals that improvements continue to be made, the charity warns that much more needs to be done to offer people timely specialist palliative care when needed.


And while there was an increase in the number of people nearing the end of life who had advance care plans, almost 63 percent of patients did not have one.


Advance care plans record people’s wishes for how they would like to be cared for in their final days, and help give people nearing the end of life comfort, dignity and choice.


Macmillan Wales highlights that the Welsh Government’s annual statement of progress report reveals:


•              A worrying 10 percent drop in the number of people with urgent palliative care referrals being seen within the recommended two days since 2012-2013.


•              Around 3 in 10 people with an urgent palliative care referral were not assessed within the recommended two days over the course of 2016-2017.


•              Although the number of people recorded on a GP palliative care register has increased, fewer than half (10,000 out of 24,000 people) were registered on the register.


•              Almost 63 percent of people don’t have an advance care plan, but it is encouraging that overall numbers have seen improvement.


Macmillan Wales believes that whether it is at home, in the hospital or in a hospice, people should be given the opportunity to record their wishes and preferences and, wherever possible, be cared for in a place of their choosing.


Any delay in urgent palliative care referrals can lead to inappropriate and unwanted medical treatments and hospital admission in the last weeks, days and hours of life.


Responding to the report, Richard Pugh, Head of Services for Macmillan Wales, said: “While this report suggests a step in the right direction, there is still a long way to go in making sure people receive the high-quality end of life care in a consistent way right across Wales.


“Much more must be done to help people receive their care and to approach the last days of their life, in a place of comfort and of their choosing.


“It is extremely worrying that 3 in 10 people faced delays in getting urgent palliative care and that so few people nearing the end of life have an advance care plan in place.


“Early conversations that are translated into an advance care plan are vital to helping people shape their care and voice their preferences for where they wish to be cared for in their final days.


“Macmillan Wales is proud to fund professionals and services to support people in need of end of life care, and we are pleased the report acknowledges the impact of our investment in End of Life Care GPs, who have improved the number of people registered on a palliative care register.


“To achieve the delivery plan’s ambitions, we need to see an unwavering focus on identifying people nearing the end of life early, offering timely advanced care planning before a person’s health deteriorates and recording patients’ wishes in an advance care plan that can be accessed easily between healthcare settings.


“We also need healthcare professionals to act upon these plans when they are in place.


“Only then will we be able to truly ensure that people with cancer and other incurable illnesses can, when the time comes, end their days in comfort, dignity and in a place of their choice wherever possible.”


If you have been affected by cancer and would like information and support from Macmillan, or call the Macmillan Support line on 0808 808 00 00.


The Welsh Government’s ‘End of Life Care: Annual Statement of Progress’ report was published on 20 December 2017.  A full version of the report is available here.