A 'good death' should be accessible to all says Bedfordshire health board in end of life care report
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The ‘Dying Well in BLMK Report 2024’ was presented to BLMK ICB on Friday (December 13).
Sarah Stanley, chief nursing director, said: “There are three main trajectories of things that we’re all going to die of.
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Hide Ad“The first is cancer, although this is reducing, it is often a very predictable decline and it’s usually quite well managed and you often live at home for a very long period of time before you move into the dying phase.


“Another one that is growing is long-term conditions [such as] non-malignant (non-cancer) diseases, such as heart failure kidney failure lung failure, as well as neurological disorders characterised by periods of decline and never getting quite back to the same baseline that you were before.
“This can take many years, between five and 10 years, until you come to a stage where you are likely to be dying, but it’s often quite difficult for clinicians to identify.
“The one that is sadly growing and growing with our population is frailty and dementia, marked by prolonged steady deterioration over time.
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Hide Ad“Often [this is] very difficult to predict when this person is going to die and can often lead to lots of hospital, sort of A&E attendance, that might lead to unnecessary investigations and interventions in hospital.
“But that is the one that is sadly increasing,” she said.
Ms Stanley said the review sought to understand the current service, its gaps, its challenges and opportunities to support the development of a full range of quality palliative care services.
“We want to be really clear that good palliative care and end of life care is a right for all of our residents,” she said.
“Currently 43 per cent of all deaths occur in hospital; between April 2023 and March 24, 32 per cent of BLMK patients who died had three or more emergency admissions in the last three months of life.
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Hide Ad“And likely lots of acute interventions that were probably unnecessary and were not going to change the ultimate outcome,” she said.
“Being registered as ‘palliative care known’ does offer significant benefits for the patient and their family and friends.
“They will get an increased support of system wrap around care for themselves, so being on that register is important.
“We do really need to strengthen our bereavement support, it is very limited in our system here across Bedfordshire Luton and Milton Keynes,” she added.
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Hide AdDr Rima Makarem, ICB chair, said: “A good death is a fantastic thing to have, and it should be accessible to everyone.
“Rather than at the moment when you’re just lucky if you’re able to stay at home.
“Or lucky if you’re not able to stay at home but you’re in a more peaceful setting like a hospice rather than in a busy A&E or a busy ward where people don’t have time to look after you.”
The ICB was asked to endorse the formation of a BLMK palliative and end of life care program board to work through the report’s 12 recommendations.
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