Pre and Post Bereavement Support: Exploring barriers to universal approach to End of Life Care

Healthwatch Staffordshire, Wolverhampton and Walsall explored the availability of pre and post bereavement support as part of a wider review of end-of-life care. Drawing on evidence from hospices, staff and service users, the research found that bereavement support provides significant benefits for people coping with grief and can reduce the risk of longer-term emotional and psychological difficulties. Service users who accessed support were overwhelmingly positive about the value of counselling, support groups and other bereavement services.

The study found that bereavement support across the three areas was generally stronger within hospices than elsewhere, particularly for pre-bereavement support, which was often unavailable outside hospice settings. Staff described national provision as fragmented and dependent on charitable services. Service users highlighted difficulties accessing support, limited awareness of available services, long waiting times in some areas and a need for more personalised and proactive support. 

Key barriers included late referrals, public discomfort discussing death and dying, a lack of awareness among families, financial pressures on services and heavy reliance on volunteer counsellors. Both staff and service users believed that bereavement support should be discussed much earlier and offered as part of wider end-of-life planning rather than only after a death has occurred.

Overall, the report concluded that bereavement support is highly valued but inconsistently available. Recommendations included incorporating bereavement support into Advance Care Planning and end-of-life care pathways, improving public awareness, widening access beyond hospice users, strengthening referral pathways and providing greater recognition and sustainable funding for bereavement services and counsellors.