Delegates were honoured to have England’s Chief Medical Officer Professor Chris Whitty join Hospice UK’s National Conference - ‘Thinking Differently’ - in Liverpool on Monday 6 November, 2023.
Addressing the opening session of the conference, Professor Whitty shared his thoughts on trends in medicine, demography and mortality. He praised the hospice sector and gave his perspective on the skills, experience and wisdom hospice care professionals can share with the wider health system.
Caring for people at the end of their lives
Professor Whitty illustrated how an ageing population will significantly increase demand for palliative and end of life care in future. Stressing the importance of the quality of that care, he argued that there was much that could be learnt from the hospice movement.
‘We should be aiming for quality of life for people in older life, not just in their last few months, but throughout older life,’ he said. ‘Dignity and quality of life should remain central. This is what the hospice movement has taught us.’
Drawing on his experience during the COVID-19 pandemic, Professor Whitty praised the care provided by the hospice sector. ‘Hospices supported people to have the death they wanted despite the enormous challenges brought by the pandemic,’ he said.
‘I have huge admiration for the hospice sector, as does the whole country. I have enormous thanks for what the sector did during the pandemic, and I want to see more being done to embed hospice and end of life care skills into the wider health and care system.’
He encouraged those who work in specialist palliative and end of life care to share their skills and experience with generalist staff in the wider healthcare system. ‘The hospice sector provides care for the whole patient, and we would like to see these skills extended into generalist nursing,’ he explained.
‘End of life care has advanced and will advance for the rest of our careers’
During his presentation, Professor Whitty used evidence looking at mortality trends over the last century.
When the modern hospice sector started, the majority of deaths were attributed to cardiovascular disease, but this has changed over time due to consistent and dramatic advances in care. Similarly, we now see better treatments for many types of cancer, and incrementally we will start to see fewer people with cancer requiring end of life care.
Professor Whitty discussed infectious diseases and their specific impact on the care people need at the end of life, in addition to increasing morbidities, such as inflammatory diseases, which will affect the types of conditions people need treatment for at the end of life.
Professor Whitty also stressed the important of looking at both mental health as well as physical health, and argued that more work was needed in this area. ‘Some conditions, notably mental health conditions, have not seen change at the same rate as some of the physical conditions, but they are equally impactful. We as a profession as a whole need to take this very seriously.’
Looking to the future: what will hospice care look like in the coming years?
Professor Whitty analysed population data, looking specifically at deprivation levels, and the disparities in the age profile of different parts of the country.
With higher levels of need among older and more deprived populations, he argued that end of life care services need to be planned accordingly.
‘This issue of a mismatch between the where the ageing population is and where the care is will be an increasingly important one for the sector in future,’ he said.
We’re also entering a period where the conditions people need care for, such as dementia or frailty, are more complex, and this is something the palliative and end of life care sector needs to find innovative solutions for.
‘We will also see that at the point people die they will have multiple, potentially unrelated diseases which will need different treatment – multi-morbidity is increasing and will continue to increase – and the palliative and end of life care sector needs to be ready to meet this.’
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