Hospice UK responds to "A Second Class Ending", a new report from CQC

Nov 02, 2017
A new report published this week by the Care Quality Commission says that homeless people face significant health inequalities, and that their average age of death is just 47 years.

"A Second Class Ending" follows up from work published in 2016, "A different ending", which included a short paper looking at end of life care for homeless people.

The key discussion points from this week's CQC report are:

  • The needs of homeless people are not well understood or considered by health and care services. Where services do exist, they are often fragmented and work in relative isolation.
  • These issues are exacerbated by a lack of training and support for frontline staff.
  • Identifying homeless people who may be dying is difficult. Involving homeless people in decisions about their treatment and care means striking the right balance between supporting them and respecting their individual choices.
  • Actively linking health care, social care, housing and voluntary services may improve the care options available.
  • Working together will help continuity of care - this needs a collaborative effort across services.
  • There must be a strategic, equality-led approach at a local level, delivering personalised care. We share examples of excellent primary care and specialist community services.
  • Hospices and primary care organisations in particular can play a key role in championing an equality-led approach.
As part of the report, CQC referenced work carried out by Dorothy House Hospice Care, and St Luke's Hospice in Cheshire, which addresses some of those inequalities for homeless people at the end of life.

Responding to the report and its findings, our Director of Hospice Support and Development, Antonia Bunnin, says:

"We look forward to exploring the ideas shared in this thoughtful paper.

"‘A second class ending’ provides valuable insights on the complex barriers that prevent many homeless people from experiencing good care at the end of life. We agree that a “concerted collaborative approach” is needed to  remove these barriers and to champion an equality-led approach. 
Hospice UK is working with Homeless Link and other partners to better understand how end of life care providers can address the needs of homeless people, and identify effective practice examples, such as those mentioned in the paper.

"We will be producing some tailored resources in early 2018 to support hospices, other health professionals and commissioners in ensuring high quality support for homeless people." 

You can find out more about the research and its findings, by visiting the CQC website.



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