It is not the case that only 19% of National Health Service trusts offer palliative care. The latest National Clinical Audit of Care of the Dying (2014) showed that, of the 131 trusts surveyed, all trusts offered at least a five-day face-to-face specialist palliative care service, including 21% of trusts offering at least a 7-day face-to-face service. 91% of trusts offered an out-of-hours specialist palliative care telephone service.
Effective pain control is one of the key elements of palliative and end of life care, as noted in One Chance to Get it Right, the report published in June 2014 by the Leadership Alliance for the Care of Dying people. The Five Priorities for Care of the Dying Person, which are set out in that report, state that an individual plan of care, which includes pain relief as part of symptom control, should be agreed, coordinated and delivered with compassion for every person approaching the end of life.
The Priorities for Care also highlight the importance of sensitive communication, and state that discussions involving staff, people nearing the end of life and those close to them should be conducted in a way that maximises privacy.
We would expect NHS organisations and staff to do all that they can to ensure that this happens for all people nearing the end of life.