A national review of end-of-life care has found many hospitals are failing to provide face-to-face palliative care specialists around the clock.
The review shows only 16 of 142 hospital sites offer specialists on site 24/7.
The report is the first since the controversial Liverpool Care Pathway was scrapped.
NHS experts acknowledge steady improvements in the last two years, but warn there is still work to do.
The Liverpool Care Pathway was phased out amid criticisms it had been misused as a tick-box exercise, leaving some patients without food and water.
In its place a series of guidelines has suggested moving away from a one-size-fits-all approach, instead focusing on individual care.
This report, led by the Royal College of Physicians, shows there have been broad improvements in all areas.
Researchers found, for example, that communication with patients and relatives had improved.
But there were still a number of concerns.
In 18% of the 9,000 patient notes researchers examined, there was no written evidence to suggest that do-not-resuscitate decisions had been discussed with relatives or friends.
And in around 3,000 notes there was no evidence that the patient’s ability to eat and drink had been assessed on the last day of life.
But the researchers’ main concern was that many patients and doctors did not have full access to on-site palliative care specialists at evenings and weekends.
The majority of hospitals did offer a specialist telephone helpline at all times and 53 of 142 hospital sites offered face-to-face palliative care on Monday to Sunday between 9am to 5pm.
But for 26 trusts there was no record of face-to-face specialist palliative care involving doctors at any time.
Study-lead Dr Sam Ahmedzai, argues the situation is not good enough.
He said: “We know that most front-line doctors and nurses giving end-of-life care do it to a very …read more
Source:: BBC UK