To ensure staff are providing palliative care for patients in hospital, ward doctors and nurses need more training.
On the 4th of September 2015, The Times reported on patient’s receiving inadequate end-of-life care due to a lack of training for doctors.
The article reports on expert opinion that the medical profession is too focused on the ‘war on disease’ to give adequate time to end-of-life care. This opinion expresses that doctors may be too scared to discuss death or a patient’s needs, and that simpler touches such as consoling bereaved relatives are being neglected. 
There is a serious gap in palliative care provision in hospitals. In a 2014 report by the Royal College of Physicians, it was reported that only 21% of 150 individual hospital sites surveyed had access to face-to-face palliative care services 7 days a week. This is despite a longstanding national recommendation that this be provided. 
However, this news article highlights a further need: To provide a satisfactory level of training to doctors and nurses who may not necessarily be palliative care specialists.
Despite national recommendations to provide such training, the 2014 report by the Royal College of Physicians found that only 19% of trusts surveyed required doctors to undertake mandatory training in care of the dying. 28% of these trusts required nurses to undertake this training. Furthermore, 18% had not provided any end of life training.
PATCH is committed to ward staff increasing their palliative care skills and ensuring adequate specialist palliative care staff are available.
The needs of patients nearing the end of their life will only be met when all ward staff are comfortable looking after patients (and their families) with palliative care needs, and specialist staff are available to advise on more complex issues including hard to control pain.
Hospitals need more nurses and doctors with palliative care skills. End of life care in our hospitals should be as good as care at the beginning of life.
This message, among other comments, are given below in PATCH’s letter responding to the news article in The Times.
Oliver Moody (4th September) stated that “hospitals struggle to cope with patients who are dying”. Over 50% of people in the UK die in hospital, yet often there are only a handful of specialist palliative care nurses and doctors working with ward staff for hundreds of patients that require end of life care. Only 5% of people die in hospices operated by specialist nurses and doctors caring for perhaps 20 – 30 patients.
Hospital patients deserve to have the same quality of care as in a hospice. In a busy hospital with conflicting pressures, it takes extensive training and skill to recognise when a patient is dying, ensure patients are comfortable and free of pain in their final days, and discuss everything with patient and family. Hospitals need more nurses and doctors with palliative care skills. End of life care in our hospitals should be as good as care at the beginning of life.
PATCH is a new charity dedicated to ensuring patients and their families have access to skilled palliative care 24/7. We strongly encourage people passionate about end of life care to contact us at patchscotland.com.
Sir Michael Nairn Bt Chairman
Dr Pamela Levack Medical Director
PATCH Scotland, Dundee
References and Footnotes
- The Times. Lack of training blamed as doctors fail dying patients, Article, [Accessed 7 Sep 2015]. ↩
- Royal College of Physicians. National care of the dying audit for hospitals, England National report May 2014, [Accessed 7 Sep 2015]. ↩