Shouldn’t everyone be entitled to this? The answer is surely ‘yes’. However a report by the Care Quality Commission this year ‘A different ending: Addressing inequalities in end of life care’ says that palliative care should be personalised and tailored to each person’s needs  – yet some marginalised people (e.g. those who are homeless or living in poverty, who have mental health problems , refugees and asylum seeker, lesbian, gay bisexual and transgender comunities)get poorer care because there is a lack of awareness and understanding about their individual needs. Steps need to be taken to redress this says the CQC.

Palliative Care Expert Jane Carpenter is doing just this. She is the Macmillian clinical outreach nurse specialist for the Macmillan Cancer Care and St Helena ‘Safe Harbour Project’ set up in February this year see It’s a ground-breaking service which aims to increase good end of life care (this means letting people know what is on offer, their options, organising appropriate services and support, in the hope of avoiding crisis management and inappropriate hospital admission) to people who are marginalised  and may feel rejected and alienated by society.

She goes to where her clients are which means working across boundaries and working in NHS settings, in the community and with voluntary groups.  Her most important task is to build a relationship with each person based on trust and respect and to understand that those she is reaching out to have often suffered huge losses and may well be deeply  suspicious of her. Her aim is to have an open mind set her judgements to one side and to apologize if she’s got something wrong and to say let’s start again.