End of life care

How is the oldest population in the world – Japan – coping with the long-term health and social care needs of its population?

That is the question that a new report published by the Nuffield Trust attempts to answer:Caring for an ageing population: points to consider from reform in Japan.

I was one of a group who visited Japan as part of this project. In the report we describe how Japan introduced compulsory social care insurance to pay for care in older age.

Briefly, everyone over the age...

As in many other developed countries, the UK population is rapidly ageing. This has implications for the provision of health and social care, as older age and life-limiting, chronic conditions are closely linked. There is a growing need for palliative care.

One of the key values of palliative care is to enable people to choose where to be cared for at the end of life. When asked for their...

At last! We found evidence of an intervention which improves quality and reduces hospital costs. Is it telehealth? No! Is it greater competition? No!

It is care by Marie Curie at the end of life. People receiving the home-based Marie Curie Nursing Service were more likely than matched patients to die at home, according to their wishes, rather than in hospitals, and less likely to have unplanned hospital care.

This was our first excursion into examining the impact of home-based care from the 'third' sector – hopefully the first of many.

On...

What role should social care play to support someone at the end of life to die in their own home? And how can health and social care services work together to make this choice a reality?

Macmillan Cancer Support’s own research shows that, with the right support, 73 per cent of people with cancer would prefer to die at home – but only 27 per cent actually do. If people’s end of life wishes are to be respected, it is vital that we answer these two questions.

Macmillan has been...

Most developed countries have problems with the percentage of their gross domestic product (GDP) spent on health, so our problems are not unique.

The theory goes that in order to meet the challenge of future health care demand due to changing demography, lifestyle and new technology innovation, resources must shift into more community, home-based and self-service provision.

There appears to be consensus at the policy level that it is in the interest of patients and service users that a more integrated approach should be developed. Underpinning this is an assumption that...

While changing demographics are putting considerable pressures on health and care systems in all Western countries, nowhere is it more acute than in Japan. A baby girl born today in Japan can expect to live to 86 and a baby boy to 79. By 2030, almost one in three people will be 65 or older.

Meeting the needs of an ageing population, against a backdrop of a diminishing total population, presents an enormous challenge for its Government. Yet Japan manages to provide universal health care coverage for its population (albeit with some co-payments) while spending around 8.5 per cent of...

Last week saw the publication of the findings from the independent review of palliative care funding led by Tom Hughes-Hallet. 

Here at the Nuffield Trust we have been doing work around social care use at the end of life and it is nice to see that work being used by the report team.

We are also about to publish some work looking at the variation in hospital use in the last 12 months of life. One of the observations from this research is that to change the system...