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London is rated poorly in care for patients at the end of their lives

Released: 28 November 2012 Download PDF

The quality of care, dignity and respect shown to patients in the last three months of their lives shows a wide variation throughout England.

A first-time report from the Office for National Statistics (ONS), The National Bereavement Survey, reveals that the South West region was regularly rated in the top 20 per cent in terms of patient care and support for families and carers. However the London region received the poorest ratings, being regularly in the lowest 20 per cent.

In terms of quality of care only North Central London in the London area reached the top 20 percent but North East, South East and South West London were in the lowest 20 per cent.

When bereaved relatives were asked if they agreed that enough help was given by medical and care staff to help the patients personal needs Outer North East London and South East London fell into the bottom 20 per cent. The majority of areas in the North East, North West and Yorkshire and Humber were in the top 20 per cent in terms of quality of care and also in showing dignity and respect to the patients.

The East Midlands, West Midlands and East of England regions showed a mixed picture.
The report – National Bereavement Survey (VOICES) by PCT Clusters, 2011, looked at Primary Care Trusts (PCTs) throughout England to assess the experiences of care in the last three months of life for adults who dies in England between November 2010 and June 2011. It allowed comparison of care for different settings, for different conditions and in different areas. It was commissioned by the Department of Health (DH) and administered by the ONS.

The End of Life Care Strategy was published by the DH in July 2008 and set out a commitment to promote high quality care for all adults at the end of life and stated that outcomes of end of life care would be monitored through surveys of bereaved relatives (VOICES – Views of Informal Carers – Evaluation of Services). The sample taken in was one in six adults in England who died during the period examined.

Background notes

  1. All processes related to the administration of this survey were carried out within ONS. The selection of a representative sample of approximately 49,000 was undertaken in SAS to ensure representation of all strata and to produce probability sampling weights and stratification values. Non–response weights were created to adjust for bias in response using the same five characteristics: age and sex of the deceased, cause of death, place of death and geographical spread. The sampling method was designed to ensure that the sample represented the deaths in England for this period taking these five factors into account and the sampling stratification was designed for England–level analysis
  2. Confidence intervals provide a measure of the variability, error or uncertainty surrounding a value. They are especially important when using findings from a sample rather than the whole population and are calculated around the estimated value to give a range in which the true value for the population is likely to fall. The width of the confidence interval depends to a large extent on the sample size and so larger studies tend to give more precise estimates of effects (and hence have narrower confidence intervals) than smaller studies. Thus, wide confidence intervals show greater uncertainty and narrow ones show greater confidence in the estimated value. 
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  4. ONS official statistics are produced to the high professional standards set out in the Code of Practice for Official Statistics.  They undergo regular quality assurance reviews to ensure that they meet customer needs. They are produced free from any political interference
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