Emergency admissions at end of life set to sky rocket

Emergency admissions at end of life set to sky rocket

Marie Curie says that the NHS is struggling to cope with A&E admissions of people who are in the last year of their lives. The terminal illness charity says the situation will hit crisis point if care provided in the community is not significantly improved.

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, and 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’.

Dr Katherine Sleeman, NIHR Clinician Scientist and consultant in palliative medicine at King's College London:

 "Most people who are approaching the end of their life wish to remain at home for as long as possible, and to avoid emergency admissions to hospital. While emergency hospital treatment is sometimes necessary, we know that better care and support in the community could help reduce reliance on acute care. Given the number of people who die each year is going to increase significantly over the next two decades, attention must urgently be given to evaluating and resourcing effective models of community care for people approaching the end of life."

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