England & Wales Health and social care

A Good Death: the role of the local authority in end of life care

We do know, however, that most of us would prefer to die at home. Research shows that 70 per cent of adults would like to be cared for and die in their own home [1]. But the great majority of us still die in hospital, and only two out of ten are able to remain in their homes in their final days.

Whilst in recent years there has been progress within the health sector, with the NHS publishing its End of Life Care Strategy in 2008, the engagement of local authorities has been more mixed. This is significant because many local authority services, such as social care and housing, are crucial components when delivering high quality end of life care.

With this in mind, we recently published a report with Home Group, A Good Death: the role of the local authority in end of life care, which examines the role of local authorities in end of life care provision and considers how councils can best develop their part in this important service provision.

As part of research, we surveyed 91 upper tier councils. Our survey revealed some interesting findings:

  • Six out of 10 respondents thought that their existing end of life care arrangements would not be sufficient in future.
  • Four out of 10 thought that Health and Wellbeing Boards should lead on end of life care in future. However, only three out of 10 said that their shadow health and wellbeing boards had identified end of life care as a priority.
  • Only a quarter of respondents said that housing departments were engaged with social care on end of life care issues, despite the often crucial role of housing in supporting quality of life outcomes.

Our report highlights how a lack of collaboration between local agencies leads to more people dying in hospitals, rather than in the manner they choose.

This trend can, however, be reversed. Councils, with their new convening powers through the Health and Wellbeing Boards, are ideally placed to bring together health, social care and housing. Our report therefore calls for councils to take ownership of the end of life care agenda in order to enable people to spend their final days in dignity.

[1] NatCen survey on attitudes towards dying, death and bereavement commissioned on behalf of the Dying Matters coalition, July – September 2009