The care plan in his pocket

A nurse in a Marie Curie and Nursing Standard poll told of an older man who kept a paper care plan in his pocket. He wanted to make sure nobody did something to him that he had already said he did not want. The plan lived on him because it could not be trusted to live anywhere else.

The survey asked 1,153 nurses and other healthcare staff across the UK. Fifty-five per cent said they had treated a dying person in a corridor, or in some other space that was never meant for it. More than seven in ten said those places stripped people of dignity and left families distressed. Staffing was the constraint named most often; time came close behind. More than a third had watched CPR they thought was the wrong thing to do. One described a terminally ill woman who died on a bathroom floor.

A corridor has no door. Professor Lynn Woolsey, chief nursing officer at the Royal College of Nursing, told Nursing in Practice that people at the end of life are being treated, using the toilet, and sometimes dying "in full glare of the public." Those stretches of floor also lack the basics a nurse needs: oxygen, suction. The college's wider point is how people get there. District nurses are how many stay comfortable at home. The Nuffield Trust counted a 43 per cent fall in NHS district nurse roles in England between 2009 and 2024, from 7,643 to 4,322. For every five there were, there are now three. Relative to an older, larger population, they put the drop at 55 per cent.

People still write down what they want. Nurses in the same poll said those wishes often sit on paper, in a file the next team cannot open. Sarah Williamson, Marie Curie's director of nursing and quality, put it plainly: when someone has taken the time to think about how they want to die, that decision should follow them. Today the Health Bill is back in the Commons for report stage. The Hansard Society notes that day one includes the proposed Single Patient Record: a statutory hook to build one file, with who may open it left mostly to later regulations. Marie Curie wants that file available to every palliative and end-of-life team, including social care, hospices and other voluntary providers, so a pocket is not the backup plan.