Hospice patients 'missing' care

Patients in hospices in the UK and the Republic of Ireland may not be receiving the psychiatric care they need, a study has suggested. A survey of 166 hospices found 45% did not have any access to a psychiatrist or psychological care, the Journal of the Royal Society of Medicine reported. The study is published as a Mori poll shows the majority of people think the government should boost hospice funds.

Campaigners said both were evidence hospices needed extra resources.

The poll showed eight out of 10 people believe half of hospices' funding should come from the government. They currently receive an average of 26% from this source. The charity Help the Hospices warns most are suffering a real terms cut in funding.

The poll of 2,000 people showed nine out of 10 believe every terminally ill patient should have access to hospice care, although only 50% do.

An estimated 10% of terminally ill cancer patients - who make up the majority of those in hospices - are likely to benefit from psychiatric or psychological treatment. But researchers, based at the Institute of Psychiatry, say improving the care available is particularly important with the possibility of an Assisted Dying Bill. If such a bill did become law, it would increase the need for a reliable assessment of the psychiatric health of the terminally ill, they say.

The survey found that while just under half did not have access to a psychiatrist or a psychologist, 86% had access to a complementary therapist and 51% to a creative therapist. NHS watchdog NICE says all palliative care services should provide a range of psychiatric help, from basic support from all staff to specialised services for those who need them. The researchers say the study shows there is a clear gap between what NICE recommends and the reality in hospices.

Psychiatrist Dr Max Henderson, who worked on the study, said: "There is an increasing awareness within palliative care that the mental wellbeing of a patient is an important aspect of their care. Hospice care is not just about the last few days of weeks of a person's life, sometimes people live for several months or years. While many hospices provide that support, the very end of a patient's life is a very difficult time, the NICE guidelines reflect this and it is crucial that these guidelines are met."

David Praill, chief executive of Help the Hospices said the study raised concerns. "It indicates that limited resources are partly to blame, and yet again this seems a case of not making the needs of terminally ill people a high enough priority. We are urging the government through local primary care trusts to improve the funding available to charitable hospices. Hospices are mostly independent charities, struggling to make ends meet and doing an incredible job with the resources they have."

A Department of Health spokesperson said: "We acknowledge that there is a lot more to be done. In 2004, NICE published definitive guidance on supportive and palliative care. The 34 cancer networks in England are now developing action plans to ensure that this is implemented. We are also investing £6m over two years in a series of integrated cancer care pilots, which will develop and deliver a model to help patients get the best quality of care possible and to find out the most effective ways to use resources."