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Emergency admissions at end of life set to sky rocket

Boost NHS community services urgently so enough beds and staff to ensure good end of life care

Louise Prime

Thursday, 22 March 2018

We need urgently to confront the realities of an ageing population and its impact on our health and care services, and boost NHS community services so there are enough beds and staff to ensure good end of life care, NHS Providers have insisted. They were responding to the findings of a Marie Curie report*, which found that the NHS is already struggling to cope with A&E admissions of people who are in the last year of their lives – and that emergency admissions at the end of life are set to sky rocket.

The charity said its new analysis of data from NHS Wales, NHS Scotland and NHS Digital revealed that there were more than 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 about 11 million days in hospital; and that adequate care in the community could often prevent such emergency admissions.

It warned 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 – and that up to 8,000 extra hospital beds could be needed by 2038. It pointed out that this is the equivalent of an extra ward in every hospital with a major A&E unit. It added that the situation is particularly dire in England, which has almost twice the average number of emergency admissions in the last year of life compared with Scotland and Wales.

The charity’s director of policy and public affairs Simon Jones commented: “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… 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.”

NHS Providers back up Marie Curie’s findings. Deputy chief executive Saffron Cordery said: “People have a right to expect appropriate care in the right setting at the end of their lives. This report makes clear that we need to boost NHS community services so there are enough beds and staff to ensure good end of life care.

“It is urgent that we confront the realities of an ageing population and its impact on our health and care services. People are living longer, but with more complex care needs and often multiple long-term conditions. This is driving emergency admissions up unsustainably.”

Marie Curie noted that previous research by the Nuffield Trust has shown that more widely available community support could result in potential savings, as hospital costs account for the large majority of costs in end of life care.

Dr Adrian Boyle, chair of the Quality Emergency Care Committee at the Royal College of Emergency Medicine, said: “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.”


*Emergency Admissions report. Prepared by Marie Curie, March 2018.

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