Staff shortages and increased caseloads prevent effective pain management at home for dying people

May 13, 2017
Only around half of healthcare professionals who support dying people at home say staffing levels are sufficient to meet their pain management needs according to new research published today.

Fifty-one per cent of those surveyed said staffing levels were sufficient to meet needs, while more than a third (35 per cent) said they were not.

And many healthcare professionals supporting dying people are over-stretched with one in five of those surveyed (20 per cent) describing their caseload as “not manageable”.

Nearly a third (29 per cent) of respondents described the availability of end of life care training in their area as either “requiring improvement” or “inadequate”.

A quarter of those surveyed (25 per cent) said they had no access 24/7 telephone end of life care advice for people at the end of life, their families and carers.

The charities Hospice UK and the National Council for Palliative Care (NCPC) surveyed 370 healthcare professionals across England who work to support dying people at home. They included community nurse specialists, hospice service leads and GPs.

Many people want the choice to be able to stay at home at the end of their lives, which is supported by Government and NHS England policy. However, pain management for people approaching the end of life being cared for at home lags far behind that of other care settings, including hospice inpatient units, care homes and hospitals.

The joint report sets out new guidance for service providers and Clinical Commissioning Groups to help improve pain management for dying people at home. It reinforces existing policy guidelines on end of life care such as the NICE quality standard and the Ambitions for Palliative and End of Life Care framework. 

Tracey Bleakley, Chief Executive of Hospice UK said:

“Inadequate pain management for dying people being cared for at home due to issues such as staff shortages is unacceptable. People approaching the end of life should not be forced to make a trade-off between staying at home, where they would prefer to be, or going into hospital for effective pain relief.  

“We hope this research will serve as a wake-up call for commissioners and providers to take concerted action to tackle the underlying issues depriving dying people of effective pain management at home.”


Claire Henry, Chief Executive of the National Council for Palliative Care, said:

“We know both that people’s top priority for their end of life care is being pain free, and that most people would choose be at home when they die. So it’s essential to make sure people dying at home have round the clock access to effective pain relief. 

“We need new approaches to achieve this, including giving training and support to carers so they can give injections if that’s wanted. Everyone has a right to good end of life care; this issue needs to be addressed promptly and successfully.”

The survey follows research published by Dying Matters last week which found that 39 per cent of people would be willing to give an injection after receiving some training, in order to relieve pain or ease symptoms in someone who was dying. This rises to 61 per cent if a doctor or nurse was on hand to supervise the first few times.

Notes to editors
  • A copy of the full report is available on the Hospice UK website here and also on the NCPC website.
  • Pain management of dying people supported at home has been consistently rated as poor compared to other care settings in previous research such as the annual VOICES survey of bereaved people.

This research was commissioned by NHS England as part of the Strategic Partner Programme, which includes Hospice UK and NCPC.

About Hospice UK

Hospice UK is the national charity for hospice care and the only membership body for organisations providing hospice care.

We support and champion the work of more than 200 of these organisations across the UK.

  • Hospice UK is the national charity for hospice care and the only membership body for organisations providing hospice care. We support and champion the work of more than 200 of these organisations across the UK.
  • Hospices, and other organisations which provide hospice care, offer vital care for people with terminal or life-limiting conditions and also support their families and carers.
  • For further information about hospice care visit our website www.hospiceuk.org or follow us on Twitter @hospiceukPA.
  • Get all the latest news from the hospice and palliative care sector, as well as patient stories, on ehospice UK at: www.ehospice.com/uk This service is managed by Hospice UK. You can also follow ehospice news on Twitter at @ehospicenews

Media enquiries:

Please contact Suzanne Stevenson on 020 7520 8296 or by email at s.stevenson@hospiceuk.org. For out of hours media enquiries please call 07881 940318.

About The National Council for Palliative Care (NCPC)

The National Council for Palliative Care (NCPC) is the umbrella charity for all those involved in palliative, end of life and hospice care in England, Wales and Northern Ireland. 

We believe that everyone approaching the end of life has the right to the highest quality care and support, wherever they live, and whatever their condition.

We work with government, health and social care staff and people with personal experience to improve end of life care for all.

Since 2009 NCPC has led the Dying Matters coalition. Dying Matters is a coalition of 30,000 members across England and Wales which aims to help people talk more openly about dying, death and bereavement, and to make plans for the end of life.

Its membership includes hospices, care homes, NHS organisations and staff, GPs, funeral directors, the legal sector, charities, faith groups and many more.

For media enquiries contact Toby Scott on 020 7697 1525 or 07795 158003 out of hours.

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