People from certain groups in society sometimes experience poorer quality care at the end of their lives because providers do not always understand or fully consider their needs, according to A different ending: Addressing inequalities in end of life care”, a new review that we've published today.

We spoke with people who may be less likely to receive good care – whether because of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances – to tell us about their experience of end of life care, and the barriers which may prevent them from experiencing good, personalised care at the end of life.

We found:

People from certain groups in society are experiencing poorer quality care at the end of their lives than others because providers and commissioners do not always understand or fully consider their specific needs.

Some commissioners and providers might not be fulfilling their duties under the Equality Act 2010 as all public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work.

Health and care staff are not always having conversations with people early enough about their end of life care. This means they don’t have the opportunity to make plans and choices with their loved-ones about how and where they would prefer to die.

We identified examples of good practice, but found that action is needed to make sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.

Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said:

"A person’s diagnosis, age, ethnic background or social circumstances should not affect the quality of care they receive at any point, but certainly not at the end of their lives. What is important is that everyone receives care based on their individual needs, delivered with compassion and sensitivity by staff with the right skills, and that there is regular and effective communication between staff and the dying person and their family.

“We found that where commissioners and services are taking an equality-led approach, responding to individuals’ needs, people receive better care.

"We are committed to encouraging the improvements in services that are needed so that everyone receives the high-quality and personalised care they deserve at the end of their lives.”