Health board launches new plan to reshape end-of-life care in south Wales

A health board is aiming to reshape the way care is provided to patients with life-limiting conditions after unveiling a new palliative and supportive care plan.

To deliver the plan, Cardiff and Vale University Health Board will be working closely with voluntary sector partners including Macmillan Cancer Support, Marie Curie and City Hospice.

Around 3,900 people die from a palliative condition in Cardiff and Vale each year, and this is predicted to reach 5,000 by 2040.¹

The healthcare system often ends up admitting people to hospital, who are dying, for more than four weeks in the final year of their life. Despite 81% of people saying they would wish to die at home when the time comes, 43.4% of deaths occur in hospital.²

The new palliative and supportive care plan is designed to help people in the last year or two of their lives to get more personalised care, with more support at home and fewer unnecessary hospital visits. The aim is to help people spend their final months in the way that feels right for them.

Through reshaping end-of-life services, the new care plan will ensure people get fair, timely and responsive support when they need it most.

The plan focuses on bringing services together more effectively, improving coordination and reducing gaps in care, so people have a better and more consistent experience at the end of life.

The care plan will support care to be accessed more locally within the community and bring together care from the hospital, community, and voluntary sectors.

Colleagues have also seen a large improvement in the quality of care for patients since undertaking this work. 93% of colleagues have changed the way they refer, and this has led to more patients accessing supportive care than in the past.³

Patients have also reported improved outcome. In a survey of 205 non-cancer patients, 94% felt involved in decision making, 72% reported an improved quality of life, and all would recommend the service.⁴

By using an outcomes-based approach, Macmillan is changing the way health and care services are funded, so more people receive the support they need and ultimately deserve.

A key part of this work is integrating palliative and end of life care services locally and delivering services that are aimed at improving patient outcomes and reducing hospital stays.

The new plan being unveiled with Cardiff and Vale University Health Board is supported by the Macmillan End-of-Life Care Fund, with the hope it helps more people access personalised, flexible care that meets their needs, where they are.

Clea Atkinson, Clinical Lead for Palliative and Supportive Care in Cardiff and Vale said: “Every person deserves care that honours their wishes and supports their dignity.

“By integrating our teams and embedding supportive and palliative care earlier, we’re creating a proactive, person-centred approach that ensures people receive the right care, in the right place, at the right time.

“This represents a fundamental shift towards a more sustainable, equitable system and one that truly responds to what matters most to people”.

Richard Ball, Head of System Investments at Macmillan Cancer Support says: “Too many people spend their final months in and out of hospital when what they want most is care that supports them at home and in their community.

“This partnership with Cardiff and Vale University Health Board is helping to change that; creating joined-up, personalised palliative and supportive care so people can live as well as possible and spend their final months in the way that feels right for them.

“Backed by Macmillan’s End-of-Life Care Fund, and delivered through a sustainable social investment model, this approach aims to improve outcomes while ensuring long-term financial sustainability.

“Under this model, once the agreed outcomes have been achieved, funds are returned to Macmillan, enabling us to reinvest in further innovations that give people the compassionate, tailored support they deserve, close to home.

Sources

[1] Cardiff and Vale University Health Board (2024) ‘Quarterly Mortality Reports’. Available online at: https://cavuhb.nhs.wales/about-us/citizens-report/our-safety-systems/mortality-reviews-and-mortality-rates/quarterly-mortality-reports/

[2] Hunt, K. J., Richardson, A., Darlington, A.-S. E., & Addington-Hall, J. M. (2019). BMJ Supportive & Palliative Care, 9(1), e5.

[3] Cardiff and Vale (2022) Value in health funded service review.

[4] Cardiff and Vale (2022) Value in health funded service review.