Photograph — Wall-arm

According to a report by The Economist Intelligence Unit (EIU) released yesterday, the UK ranks first in the 2015 Quality of Death Index (end-of-life care), with a 93.9 out of 100 rating. The index measures the quality of palliative care in 80 countries around the world, and ranks comprehensive national policies, the extensive integration of palliative care into the National Health Service (NHS), a strong hospice movement, and deep community engagement on the issue. Australia, New Zealand, Ireland, and Belgium followed in this order to complete the top five on the list, while Iraq, Bangladesh, Philippines, Nigeria, and Myanmar were the bottom ten.

Areas in which the UK was scored highly include the availability of specialised palliative care workers, affordability, and the way that countries have a plan for palliative care. It scores particularly well in the former area, owing to the UK’s long history of providing treatment in palliative care.

Although end-of-life care (which includes palliative care) is still not a plan that people with terminal or life-threatening illnesses and their families readily embrace, it is steadily gaining more grounds and popularity globally due to its usefulness.

On October 1, the Worldwide Hospice Palliative Care Alliance (WHPCA) called for palliative care to be addressed as an urgent priority to meet the new adopted sustainable development goal (SDG) to ensure healthy lives and promote well-being for all, at all ages.

However, end-of-life care is still very much concentrated in the wealthy regions of the globe. The results for palliative care usually shows developed countries in Europe and Pacific Asia, and North America at the top. According to the WHPCA, despite the cost-effectiveness of palliative care and it’s capacity to improve well-being, it remains neglected in the health response.

“People should live as healthy lives as possible right through to the end of life without suffering avoidable pain and distress. Palliative care helps achieve this; the goals of palliative care being best possible quality of life and active living until death. Contrary to long standing myths, this is not the luxurious pinnacle of the health response but the absolute basic and minimum that anyone should expect”, stated Liz Gwyther, Chair of the WHPCA.

The level of incomes generated in wealthy countries plays a significant role in palliative care, thus enabling them to perform better than poor or developing countries. Not surprisingly, many developing countries are still unable to provide basic pain management due to dysfunctional health sectors.

This year, however, some countries with lower income levels demonstrated the power of innovation and individual initiative. These included Panama (who was 31st on the list), Mongolia (28th), and Uganda (35th), which underscores that if developing and low income countries are committed to provide good hospitals and hospice environments, staff with skills, and affordability- quality of care can be improved.

The UK was top in the first Quality of Death Index which was produced in 2010, although limited to just 40 countries at the time. Also, the UK does not depend solely on the government or patients fees to develop its healthcare services. About 80% to 100% of end-of-life care services in the UK are chariy funded. The Dying Matters Coalition set up by the National Council for Palliative Care Charity in the UK has been praised for encouraging people to talk more openly about death and make plans for the end of their lives.

All its achievements notwithstanding, the EIU study states that the UK still has room to improve, while highlighting issues such as poor symptom control, poor communication and planning, not responding to the needs of the dying, inadequate out-of-hours services, and delays in diagnosis and referrals for treatment.

For more insight on the 2015 Quality of Death Index (end-of-life care), listen to the podcast below

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