New data collected by Marie Curie has revealed there were over 1.6 million emergency admissions for people in the last year of their life in Britain in 2016, costing the NHS £2.5 billion and amounting to around 11 million days in hospital.
Emergency admissions to hospital for people in the last year of life can often be avoided if adequate care in the community is provided.
The charity warns that the significant rise in the number of deaths over the next 20 years means the cost of emergency admissions for people in the last year of life could almost double – costing the NHS an extra £2 billion. Up to 8,000 extra hospital beds could be needed by 2038 – the equivalent of an extra ward in every hospital with a major A&E unit.
Marie Curie’s analysis of the data paints a particularly bleak picture in England compared to Scotland and Wales. The average number of emergency admissions in the last year of life in England is nearly twice as many as in Scotland and Wales, meaning that dying people are being rushed to hospital much more often.
Simon Jones, Director of Policy and Public Affairs at Marie Curie said:
“Unnecessary hospital admissions are a huge cost to the NHS and as the number of people dying each year is set to increase significantly, we need to address the provision of care now in order to avoid further crisis. Government has already stalled on its green paper on care and support for older people until this summer but urgent attention should be given to ensuring there is proper care available in the community to avoid unnecessary pressures on A&E services.”
“While some emergency hospital admissions for people living with a terminal illness are appropriate and necessary, many are not and can often be avoided entirely if appropriate care in the community is provided. Right now dying people and their loved ones are being failed by a system under immense pressure. This will only get worse. Being rushed repeatedly to hospital is stressful and upsetting, particularly when someone may have little time left. A&E should be a last resort, not the first port of call for care. It makes an already difficult time much worse.”
Research by the Nuffield Trust has shown that hospital costs are by far the largest cost involved in end of life care – with the bulk of this due to emergency hospital admissions – and that potential savings might be made if community-based support were made more widely available.
Dr Adrian Boyle, Chair of the Quality Emergency Care Committee at the Royal College of Emergency Medicine said:
“This analysis shows the urgent need for investment in more hospital beds and social care. Social and community care plays a vital role in helping people avoid the need to go to A&E in the first place, then getting them back where they want to be when ready to leave hospital: home.”
“The last thing patients at the end of their lives want is to be in hospital. Increasing the resources available to social care will not only help reduce avoidable admissions, free up beds and relieve pressure on our struggling emergency departments, but will afford terminal patients the dignity and comfort of living out their last days in familiar surroundings.”
Marie Curie’s analysis also follows a report from the National Audit Office (NAO) that said emergency admissions “pose a serious challenge to both the service and financial position of the NHS.”
Commenting in response to the findings, Jonathan Ellis, Director of Advocacy and Change at national hospice care charity Hospice UK, said:
“Marie Curie’s new data is a stark reminder of the need to reassess provision of care for people at the end of life and invest more in community services. Current provision is skewed towards hospitals which is creating unnecessary pressures on already over-stretched services and means that people are not always getting the right end of life care in the right place for them.”
“This issue urgently needs to be tackled now otherwise things will only get worse over time given the increasing care needs of our ageing population.”
“Hospices play a vital role in preventing emergency hospital admissions for people approaching the end of life and many are working in partnerships with their local hospital. This includes providing home-based care, as well as advice and support through dedicated helplines, to ensure more people are supported where their needs are best met, which is not always in a hospital. Hospice UK is leading a project to look at how hospices’ work in this area could be expanded further to improve the care that people receive out of hospital at the end of life and help reduce pressures on hospital beds.”