Palliative Care – 100,000 terminally ill Miss Out! 01-Jun-2011

Palliative Care – 100,000 terminally ill Miss Out! 01-Jun-2011
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100,000 terminally ill ‘do not get proper palliative care’

Almost 100,000 terminally ill people do not get proper care, according to a Government review which concluded that a new funding system would save millions of pounds and better serve individuals.

100,000 of terminally ill 'do not get proper palliative care'

Far more people die in hospital than wish to, and experts estimate that more than 90,000 people are not having their palliative care needs met.  Photo: ALAMY

A national payment structure would cut variation around the country in what the state pays for and what it does not, and support far more people to be cared for in their own homes, it said.
Experts behind the report say the move could reduce deaths in hospital by up to 60,000 a year by 2021, translating into savings of £180 million annually.
At the moment, the amount primary care trusts (PCTs) in England spend on end-of-life care varies widely, from £186 per patient in one area to £6,213 in another.
Access to services, including round-the-clock nursing care, also depends on where people live.
Far more people die in hospital than wish to, and experts estimate that more than 90,000 people are not having their palliative care needs met.

The Palliative Care Funding Review, ordered by Andrew Lansley, the Health Secretary, last summer, proposes a “fair and transparent” funding system where the money is linked to the individual patient.
Under the scheme, people would receive an initial assessment of their needs, which would then be combined with other factors such as their age and capabilities. 
This “needs classification system” would have 25 separate classes (13 for adults and 12 for children), each with its own pot of funding. 
The funding would take account of things such as personal care needs, including help with washing and eating, the provision of 24/7 nursing care to support people at home and a co-ordinator to help patients work out their state entitlements as well as access to local charitable services. 
At present, some end-of-life care providers are paid regardless of how much work they do, offering poor value for money across the service, the review said. 
Meanwhile, 97% of hospices do not receive all the funding they need for the NHS services they provide, and some patients are victims of “rationing” towards the end of the NHS financial year.
These latest proposals would guarantee funding regardless of where patients live and whether they are in a care home, hospital or in their own home. 
Thomas Hughes-Hallett, chair of the review and chief executive of Marie Curie Cancer Care, said: “No other country in the world has introduced such a system for both adults and children, so the step is both a bold and necessary one.”
Professor Sir Alan Craft, adviser to the review, said: “The Government must act on the recommendations contained in the review because evidence shows us that incentivising the provision of palliative care leads to better outcomes for patients, supports choice and is the most cost effective way of using NHS resources. 
“We need to remove the barriers within the current system to enable this to happen.”
Between 56% and 65% of adults would like to die at home but only 20% do so, with 55% dying in hospital. 
The ageing population and the increased complexity of needs towards the end of life mean 90,000 more people than at present could be dying in institutions by 2030, the review said.
Ciaran Devane, chief executive of Macmillan Cancer Support, said people wanted a choice over where to die. 
“Twenty-four hour community nursing services are crucial to the delivery of choice and to the realisation of these ambitious recommendations. 
“It will be up to the Government to ensure that these services are standard across the country.
“We need to see a massive improvement on the 56% of PCTs who currently provide 24-hour community nursing.” 
Simon Chapman, director of policy and parliamentary affairs at the National Council for Palliative Care, said: “It is vital that the Government acts on the review’s recommendations and creates a fair funding mechanism that will ensure people get high quality end of life care where and when they need it. 
“We only get one chance to get it right for dying people, which is why it must be a priority to ensure everyone who needs it can access palliative care round the clock.” 
Susan Munroe, Marie Curie Cancer Care’s director of nursing and patient services, said: “Far too many people at the end of their lives are still not getting the care and support they need nor do they know what they are entitled to.
“We welcome the recommendations of the review as the next big step. 

“We now want to see these recommendations implemented by the Government as a matter of urgency.”

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I Have Been Fighting Cancer since 1997 & I’M STILL HERE!
I Have Cancer, Cancer Does NOT Have Me
I just want to say sorry for copping out at times and leaving Lee and friends to cope!
Any help and support YOU can give her will be hugely welcome.
I do make a lousy patient!

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If YOU want to follow my fight against Cancer from when it started and I first presented with symptoms see The TAB just below the Header of this Blog. called >DIARY of Cancer< just click and it will give you a long list of the main events in chronological order.
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Posted by: Greg Lance-Watkins
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17-Aug-2008 – PCT Policy – OBFUSSCATED by TORTALOGOUS LANGUAGE!

17-Aug-2008 – PCT Policy – OBFUSSCATED by TORTALOGOUS LANGUAGE!

2008 August 17 18:44:32 BST
Posted By: Greg_L-W.
Discussion
Greg_L-W.’s Blog

Hi,
I note with some interest the lengthy tortalogous definition of PCT Policy which has been tracked down which follows:
[QUOTE]
This is a typical attempt of a PCT to explain why they are refusing to fund cancer treatments. This is from their policy document.
Guidance for considering exceptionality¡¦ in individual cases
Oxfordshire Commissioning Board decision – Policy Statement 80a

The Oxfordshire Case Review Committees consider requests to fund individuals for treatments which currently fall outside commissioning policies and agreements. A patient will not normally be funded, unless exceptional circumstances apply. The purpose of the Case Review Committees is to carefully consider, within the Ethical Framework, whether such circumstances exist. The key question is: On what grounds can this patient be funded when others will not be?¨ The Oxfordshire Priorities Forum gives guidance for decision making about ¡§exceptional cases¡¨. It is not appropriate to give specific examples of exceptionality. Definition of exception: A particular case which falls within the application of a rule, but to which the rule is not applicable. Definition of exceptional¨: of the nature of or forming an exception; unusual or special.
General guidelines: 1. It is stated on the Priorities Forum low priority¡¨ policies Potentially exceptionalcircumstances may be considered by the patient¡¦s PCT where there is evidence of significant health status impairment (e.g. inability to perform activities of daily living)¡¨. 2. By definition, ‘exceptional’ may not necessarily be predicted or spelt out in advance. 3. The fact that a patient¡¦s clinical picture matches ¡¥accepted indications¡¦ for a treatment which is not normally provided is not, in itself, exceptional. 4. The fact that the treatment is (or is likely to be) efficacious for a particular patient is not, in itself, exceptional. 5. Consideration will be given to evidence that shows that the benefit from the treatment for the patient would be significantly greater than would be expected for an average patient. 6. It is for the requesting clinician (or the patient) to demonstrate why they should be considered as an exception.

===========================

Individual Patient Requests
Exceptional Status (what makes the individual sufficiently different from the usual in policy terms)

Central to consideration of individual requests for funding is the concept of the case being exceptional.
In order for funding to be agreed there must be some unusual or unique clinical factor about the patient that suggests that they are:
„« Significantly different to the general population of patients with the condition in question
And
„« likely to gain significantly more benefit from the intervention than might be expected from the average patient with the condition.
However:
„« The fact that a treatment is likely to be efficacious for a patient is not, in itself, a basis for an exception.
„« If a patient‘s clinical condition matches the ‘accepted indications’ for a treatment that is not funded, their circumstances are not, by definition, exceptional.
„« Social value judgements (the ‘worth¡¦ of patients) are not relevant to the consideration of exceptional status but there may rarely be exceptional circumstances where benefits may go beyond the patient (e.g. as a carer) in respect of social or health related benefits for others.

This guide is in addition to the Oxfordshire Priorities Forum Lavender policy on ¡§Guidance for considering exceptionality in individual cases¡¨, policy number 80a.
Oxfordshire Treatment Request Panel and Case Review Committee June 2007
[/QUOTE]
Why we go to such lengths to track this sort of stuff down one has to wonder when we could so much more readily have obtained the original training manual for PCT Diktat Obfuscation when required to hide dishonesty and corruption in regulation documents.
Here is the relevant passage in the Drafting Officer’s Manual:
[QUOTE] “The fact that the Patient needed to know was not known at the time that the now known need to know was known, and therefore those of us who needed to advise and inform felt that the information that we needed as to whether or not to inform the highest authority of the known information was not yet known, and therefore there was no authority for the authority to be informed because the need to know was not yet known, or needed.” [/QUOTE]
I must admit that I have cheated a little as I substituted the word patient for prime minister in this section of speech by Sir Humphry in ‘Yes Minister‘.
For EU Regulations it may interest you to know that the Official drafting of ALL EU drivel is drawn up by French ENARCHS, who are, whilst at L’ Ecole National, it seems trained in the black arts of perfidy to write any sentence in a manner where that which is the diametric opposite of that which it would seem to indicate!
No one has yet managed to answer the simple question under Law – by which Act of Parliament are The State authorised to practice EUthenasia on selected groups? The fact that the Government shelter behind their appointed cronies in N.I.C.E., P.C.Ts. etc. makes it no less a State decision to EUthenase selected Kidney Cancer patients.
In a civilised society it is possible to judge its standards by the way it treats its weakest citizens. To administer a poison in order to kill someone is an act of MURDER – perhaps someone wiser than I in authority can explain how it is Morally any different witholding a needed and proven drug.
Be aware that – the self same Government which is advocating the deliberate Muder of certain selected Kidney Cancer patients on the grounds of cost efficacy of certain drugs has I understand sent over 600 people, besides athletes & trainers, to Beijing to watch people running around in circles or whatever – I understand the cost of an MP in terms of expenses runs to about £24K. This is the same Government that authorises the John Lewis List scam and the funding of London second homes for MPs.
More specifically this is the Government which Baroness Gardiner assured us in The House of Lords ‘spends upto £300,000,000 on tattoo removal’.
Just how can the deliberate Murder of Kidney Cancer Patients be justified?
Any ideas?
Regards, Greg L-W.

I just want to say sorry for copping out at times and leaving Lee and friends to cope!
Any help and support YOU can give her will be hugely welcome.
I do make a lousy patient!

.
If YOU want to follow my fight against Cancer from when it started and I first presented with symptoms see The TAB just below the Header of this Blog. called >DIARY of Cancer< just click and it will give you a long list of the main events in chronological order.
.
Thoughts and comments will be in chronological order in the main blog and can be tracked in the >ARCHIVE< in the Right Sidebar. You may find the TABS >MEDICAL LINKS< and also >CANCER LINKS< of help.
.
YOU are welcome to call me if you believe I can help in ANY way.
.

Posted by: Greg Lance-Watkins
tel: 01291 – 62 65 62