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<p>The Department has made no specific assessment of local palliative services care
in England. As system leader, NHS England is responsible for securing the provision
of high quality care for patients at the end of life, and as with the vast majority
of NHS services, the commissioning of palliative and end of life care is a local matter,
over which individual clinical commissioning groups (CCGs) have responsibility.</p><p>
</p><p>CCGs are best placed to understand the needs of local populations and commission
services to meet those needs accordingly, and as such, decisions to increase palliative
care service provision are for the local, not the national, National Health Service.
NHS England works to support local commissioners in improving the services they provide,
including palliative care, and has recently collaborated with Public Health England
and the Care Quality Commission to provide bespoke end of life care support to Sustainability
and Transformation Partnerships, include Hampshire and Isle of Wight. A copy of the
support pack is attached.</p><p> </p><p>Much of the palliative care patients receive
will be provided either in outpatient or community settings, by nurses, community
teams or general practitioners as part of general NHS services provision, rather than
as an identified palliative care service. In such services, data are either not available
or does not identify palliative treatment. In addition, social and voluntary sector
organisations can provide additional support to patients and the end of life. Therefore,
figures for the average cost and average time for treating a terminally ill person
and figures for the number of patients offered end of life care in the home are not
available.</p><p> </p><p>On 5 July 2016 we published ‘Our Commitment to you’ for end
of life care, which set out what everyone should expect from their care at the end
of life and the actions we are taking to make high quality, personalised care a reality
for everyone. This includes measures to enable personalisation, measures to improve
care quality and education and training in end of life care and measures to encourage
the spread of innovative models of care. The commitment sets out that by 2020 we want
to significantly improve patient choice, including ensuring an increase in the number
of people able to die in the place of their choice, including at home. A progress
report on delivery of the commitment was published on 21 September 2017.</p><p> </p><p>A
key tool in measuring choice and quality in end of life care is the National Survey
of Bereaved People (VOICES) survey, which collects the views of bereaved family and
friends about the care received by the person they were caring for at the end of life.
The survey does provide some information about preferences for care at the end of
life, including place of death. The Government Choice Commitment; progress report
on the Choice Commitment; and latest VOICES survey report can be found at the following
links:</p><p><a href="http://www.gov.uk/government/publications/choice-in-end-of-life-care-government-response"
target="_blank">www.gov.uk/government/publications/choice-in-end-of-life-care-government-response</a></p><p><a
href="http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/645631/Government_response_choice_in_end_of_life_care.pdf"
target="_blank">www.gov.uk/government/uploads/system/uploads/attachment_data/file/645631/Government_response_choice_in_end_of_life_care.pdf</a></p><p><a
href="http://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/nationalsurveyofbereavedpeoplevoices/england2015/pdf"
target="_blank">www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/nationalsurveyofbereavedpeoplevoices/england2015/pdf</a></p>
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