Two thirds of people would like to die at home if they were terminally ill, according to a YouGov survey. Nursing Standard (April 23) reports that this can be done at no extra cost to the NHS.

The King's Fund reached this conclusion after examining Marie Curie Cancer Care's Delivering Choice programme. It provides rapid response nurses for emergency and planned visits to patients in their homes from mid-afternoon through to 7am.

In 2006-07, the first year of the programme, 23 per cent of patients were able to die at home rather than in hospital, compared with 19 per cent the previous year. The cost in the last eight weeks of life averaged £5,401 for patients on the programme compared with £5,324 for those who weren't. The extra cost of community support for people at home was balanced by reductions in the numbers of GP visits and 999 calls.

“Patients tell us one of the main benefits is that there is someone to call out of hours,” says Gwen Eldred, a Marie Curie nurse who works on the rapid response team. “Their GP surgeries are closed and they cannot speak to ... a specialist in the field.”

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Pulse (April 23) says that the findings will allay fears that shifting more palliative care into the community will increase GPs' workload. The Marie Curie programme cut GP contacts per patient from an average of 4.2 to 2.2 in the last eight weeks of life.

Elsewhere, a poll of more than 4,000 people around the world by the British Medical Journal (April 25) indicates that people believe palliative care for non-malignant disease is the area of healthcare where doctors can make the greatest difference to patient care. At present, 90 per cent of care provided by hospices in economically developed countries is to cancer patients.

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