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Issues facing commissioners of end-of-life care

End-of-life care services are typically funded and delivered by a mix of providers from the health (NHS), social (local authority) and voluntary sectors (such as Marie Curie and hospices), as well as by independent agencies and through individual means (informal or family carers). Very little is known about the composition of health and social care needs of this population (National Audit Office 2008) or about the associated cost and resource implications for the sector as a whole (Hughes-Hallett et al 2011). However, we do know that there is immense pressure on PCTs and local authority budgets to meet the increasingly complex care needs associated with an ageing population, and that the current system of funding and commissioning end-of-life care is inadequate for meeting patients’ care needs and preferences.