Home palliative care: A major strategy to improve end-of-life care in UK NHS

Time and again, in every part of the world, surveys show that people with life-threatening illness want to spend as much of the time that is left at home, rather than in hospital. They aspire to die in their own surroundings, peacefully and pain free. Increasingly, clinicians, managers and commissioners of health services are recognising this and building services to meet it. In the UK NHS, it has become part of a major strategy to improve end-of-life care.

The current issue of Progress in Palliative Care (Volume 18 Number 1) features articles from authors all over the world, working in all sorts of different situations with a variety of funding streams and financial resources, describing how they provide care for patients at home. The articles have been chosen to demonstrate the breadth and depth of palliative care services in different situations.

As the number of doctors who want to go to into home care dwindles and it receives a low priority financially and academically in many parts of the world, the issue focuses on what is possible in home care in order to stimulate others to look at what their services provide and how it might be linked to other charitable and cultural initiatives in their own area. Home care can once again be a central aim of communities, not only hospices, and can bring other benefits, so bringing dying patients once again to the forefront of our minds.

An article by Mary Baines, founder of the first specialist palliative home care service, is the first extensive record by Dr Baines of the development of the service which she founded at St Christopher's Hospice, London, in 1969.

The issue features a guest editorial by Dr Sara Booth, 7 review articles and a bibliography:
• The origins and development of palliative care at home, Mary Baines
• Challenges in delivering palliative care in the community - a perspective from St Christopher's Hospice, London, UK, Barbara Monroe and Penny Hansford
• Home-based palliative care in Kerala, India: the Neighbourhood Network in Palliative Care, Libby Sallnow, Suresh Kumar, and Mathews Numpeli
• Going the extra mile with the bare essentials: home care in Uganda, Anne Merriman
• Hospice 'Casa Sperantei' - pioneering palliative home care services in Romania, Alison Landon and Daniela Mosoiu
• Territory Palliative Care - a model for remote area palliative care provision, Simon Murphy
• A model of palliative care programme integrating rural with hospital care: Sarawak, Malaysia, B.C.R. Devi, T.S. Tang, and M. Corbex
• Bibliography
General; Paediatric issues; Pain and pain relief; Symptom control; Quality of life; Psychosocial issues; Death; Loss and bereavement; Carers and families; Patient care services; Professional issues.