Models of delivering palliative and end-of-life care in the UK.

PURPOSE OF REVIEW

The development of palliative and end-of-life care in the UK has been shaped by history and circumstances within and outside palliative care itself. The main focus of this review is to describe adult palliative care services in England, although much of the historical developments apply across the whole of the UK, and some of the later developments affect children's services as well.

RECENT FINDINGS

From the pioneering days of Cicely Saunders, many landmark events have explicitly, or inadvertently, influenced the development of palliative and end-of-life care services. In the UK, it is generally recognized that there is a difference between generalist and specialist palliative care. Funding models, key reports, national strategies, and initiatives in education and training have all contributed to the journey that this specialty has undergone in this country.

SUMMARY

Although there is comprehensive coverage of palliative care obtainable across the UK and good access to medication and equipment, there remains a lot of inequity to challenge and address, including those relating to geography, diagnosis, age and ethnicity.