Dying with dignity – London’s end of life care in ‘crisis’

London has an ageing population. By 2035, the number of people aged above 60 years is predicted to rise by 48 per cent and the number aged above 80 is set to rise by 70 per cent.^[1] This will only increase the demand for end-of-life care provision in the capital.¹

Hospitals are the most common place of death in England, accounting for 42.8 per cent of deaths in 2023, but this figure is even higher in London at 48.8 per cent.²

Marie Curie believes that end-of-life care in the UK is “in crisis”, with one in four people not getting the care they need, one in three dying in overwhelming pain, and one in five unable to access GPs in the last three months of life.³

End-of-life care (EOLC) is usually defined as care for people likely to die within a year.⁴

It is intended to enable people to live as well as possible until they die, and to die with dignity.

The London Assembly Health Committee report ‘End of Life Care in London: a review’ makes recommendations including:

• The London Health Board should prioritise end-of-life care, with a particular focus on ensuring equality of access for all groups within London.
• The Mayor should use his convening powers and position as Chair of the London Health Board to drive greater collaboration between Integrated Care Boards (ICBs), NHS providers, local authorities, and hospices.
• The Mayor should ensure that his Cost-of-Living Hub includes clear signposting to financial and practical support for people receiving end-of-life care and their families.

Chair of the London Assembly Health Committee, Krupesh Hirani AM, said:

“The Health Committee followed up its end-of-life care work from 2016 with a meeting of experts to discuss progress.  Back then, the Committee recommended the London Health Board consider end-of-life care as a priority and that the GLA Health Team integrates it into any future review of the Health Inequalities Strategy. Nearly a decade on from that investigation, there has been limited progress in these areas.

“A national Marie Curie survey “painted a really bleak picture of poorly joined up services for people at the end of life”. The Mayor and the London Health Board can help to improve this picture in London.

“Variations in palliative care commissioning across London are creating complex, inconsistent pathways for patients and care providers. There are basic palliative and end-of-life care services that would benefit from a unified approach.

“Death is not a popular topic, but taking action now must be a priority for all London health care decision-makers and providers, to ensure every Londoner can have a dignified death.”