End of life care in the UK is in crisis, but we can still fulfil our vision together

With the Assisted Dying Bill debate taking place on 29 November, now is the time to highlight the issues facing people at the end of life and the ways we plan to tackle it at large.

Marie Curie firmly maintains a neutral position on the matter of assisted dying; we do not campaign for or against a change in the law. However, what we're absolutely not neutral on is the urgent need to improve end of life care and financial support for people at the end of life. With over 75 years of expertise and landmark research such as the Better End of Life Report, Marie Curie is the UK's leading end of life charity and biggest non-NHS provider of palliative care, and we are clear on what needs to change.

End of life care in the UK is in crisis with one in four people not getting the care they need, one in three dying in overwhelming pain, and one in five unable to access GPs in the last three months of life. There is a lack of overall community provision, especially access to out of hours care, which often leaves no option but to call an ambulance in the middle of the night.

It's very important for those at the end of life to be as free of pain as possible while maintaining privacy, dignity, and respect, and being with their loved ones. Today those needs are not being met, and these challenges are only going to grow. It is estimated that in the next 25 years, the need for palliative care is expected to rise by 25% – that's around 122,000 more people each year and there is currently no realistic plan by any government across the UK to address this challenge.

The reality is that far too many people at the end of life end up in hospital when they don't want or need to be there. It is the same picture in every part of the UK; more than two in five deaths occur in hospitals in England, Scotland and Northern Ireland, rising to almost half in Wales.

Reducing unnecessary hospital admissions and ensuring safe discharge of people at the end of life is a priority for the NHS. However, hospitals face an uphill battle in getting patients home quickly. There is, however, a solution.

More funding for palliative and end of life care is essential, but this should be focussed on supporting and enabling the whole system, beginning in the community where people can receive the support needed to die at home – the place most prefer. This means more support to GPs, community care, ambulances, and emergency departments. By working together, we can transform the way care is delivered, ensuring more people get the joined-up care they need to have a dignified and supported end of life journey.

As the UK's leading end of life charity, Marie Curie believes that the NHS in all four jurisdictions should be guaranteeing that palliative care provision is available to all, free at the point of use. Money should be invested into driving change and creating new services that better meet the needs of local communities, regardless of a person's terminal diagnoses, where they live, their individual circumstances, or place of care.

The statistics are stark; over a third (37%) of people who died in hospital had no friends or family present and one in seven people had been there less than 24 hours, suggesting they were likely to have been admitted in an emergency rather than a planned admission due to lack of access to proper and timely care at home or in a hospice.

Integrating palliative care specialists within primary care networks and emergency services would enable timely identification of those needing end of life care. Having 24/7 clinical support for the end of life would enable people impacted to receive the care they need, outside of a hospital environment. This would result in a significant reduction in demand on urgent care services, with more people cared for by trained professionals who can provide a range of care for both the individual affected and those impacted by their illness. It would help transform people's end of life experience and free up hospital beds for those who need them.

We ask all four governments to work with us – to define, develop, and scale the transformational services that are so urgently needed to deliver the best possible end of life experience for everyone. Achieving this would require not just funding, but also minimum service standards for end of life care, supported by national strategies with clear government and NHS leadership.

It is clear that far too many people die in hospital. We need urgent change to how end of life services are provided across all settings and services – only by doing this can we give people the end of life they deserve.

There is only one chance to get end of life care right – and when it goes wrong it can be traumatic for the dying person and devastating for their loved ones. Marie Curie is ready to step up and work with governments, NHS leadership and local providers to transform care of the dying. It's time to fix the crisis in end of life, once and for all.