Shocking report Exposes how terminate illness have effected many patients due to lack of Water at some NHS Hospital

 

Dying patients are routinely being left dehydrated and in pain during their final hours, a shocking report reveals today. 

Thousands have been denied fluids and medication – and in some cases doctors have not even told their relatives they are about to die, the report says. The authors warn that some NHS staff tended to shy away from the terminally ill and were afraid to comfort them or hold their hand. They describe this as a 'cross the road attitude'.

The major audit – which involved more than 9,000 patients – also exposes how the majority of NHS hospitals have no specialist end-of-life doctors and nurses on wards at nights and weekends.

People are terrified,' she said. 'People cross the road to avoid talking to someone who is dying, or who has been bereaved.'

'We mustn't do that in hospitals, we need to be there. If somebody's distressed, then find out why and if I can't deal with it, find somebody who can.

'Nurses can identify when things are going wrong and they need to be able to feel confident enough to deliver that. This is about being a human being, a nice person. It's not about being a skilled professional.'

More than 200,000 patients die in hospital in England every year but there have been repeated warnings over the standards of end-of-life care.

Thousands have been denied fluids and medication – and in some cases doctors have not even told their relatives they are about to die, the report says

Many of these centred on the Liverpool Care Pathway, a procedure under which food, fluid and medication was withdrawn from patients in their final hours – supposedly to reduce suffering.

The controversial policy was abolished in 2014 after a major review – which followed a Daily Mail campaign warning that it was being widely abused as a tick-box exercise.

This newspaper exposed how some patients were being denied food and fluid for days leading up to their deaths while others were being written off when they could have recovered.

NHS staff have since been issued with new guidelines instructing them to treat dying patients as individuals and respect their personal needs and wishes.

Today's report found that – on the whole – care has vastly improved as a result and the skills of doctors and nurses have been 'allowed to blossom'.

But it also highlighted 'unacceptable variation' between hospital trusts – partly due to a lack of staff, training and general attitude towards the dying.

The authors examined the records of 9,302 patients who had died at 142 hospital trusts in May 2015.

They found that for 55 per cent of individuals, there was no evidence they had been supported to drink in the last 24 hours of their life.

For 66 per cent, there was no documented evidence that they had been helped to eat or offered a feeding tube. In another 16 per cent, doctors had slipped a Do Not Resuscitate Order into medical files without discussing it with that individual nor their relatives. And in 4 per cent of cases – one in 20 – staff had failed to tell patients' close family or friends they were nearing the end of their life.

Lay member of the audit team Tony Bonser, whose son Neil died of cancer seven years ago, said: 'The two questions everybody wants to know about a relative is 'are they dying?' and 'how long have they got?'.'

 

The authors examined the records of 9,302 patients who had died at 142 hospital trusts in May 2015. They found that for 55 per cent of individuals, there was no evidence they had been supported to drink in the last 24 hours of their life 

Professor Sam Ahmedzai, an expert in end-of-life care at Sheffield University and lead author of the report, warned of 'unacceptable variation' between hospitals.

The number of times that medication was reviewed in last 24 hours varied from 20 per cent to 100 per cent, depending on where you were. Being assessed for a need of clinically assisted hydration varied from 10 per cent to 100 per cent.' But he also pointed out that in the two years since the Liverpool Care Pathway was abolished, doctors and nurses responsible for end-of-life care had been 'allowed to blossom'. The blanket policy may have 'held back' their skills – now they could look after patients as individuals to accommodate their final wishes.

The report also found that 19 per cent of patients had not been given pain relief in their final 24 hours of life while 31 per cent had not had medication for agitation.

And only 11 per cent of hospitals had specialist end-of-life doctors and nurses available 24 hours a day, seven days a week.

Dr Adrian Tookman of Marie Curie, a charity which cares for terminal cancer patients said: 'We can't ignore the fact that the vast majority of dying people and those close to them, still have limited or no access to specialist palliative care support when they need it in hospital.

'This is not right. It is critical that funding is directed towards recruiting and training doctors and nurses to provide specialist care now.'

Dr Ros Taylor MBE, clinical director at the charity Hospice UK, said: 'It is promising to see there have been some significant improvements in the care of dying people in hospitals in recent years.

'However, it is clear that pockets of very poor palliative care still persist.'

An NHS England spokesman said: 'He added: 'There are clear variations in the support and services received across hospitals and areas where improvements must continue to be made.