Better value in the NHS must include care for people with a terminal illness

A nurse helping an elderly lady with foot care

Today, the King’s Fund published a report on efficiencies across the NHS, which picked up on some of the figures from a report we commissioned from the London School of Economics earlier this year about costs of dying.

As the report points out, around 50 per cent of the half a million people who die in England and Wales each year die in hospital. Many would have experienced long and often unnecessary stays in hospital and ultimately did not want to die there.

For many of those people, being able to receive care at home would have been a far better option, both for them and the NHS. We know that people who receive our Marie Curie Nursing Service in the community are less likely to use hospital services, much more likely to die at home and have a £500 reduction in total care costs compared to people in hospital.

However, although it is important in the current economic situation to ensure that resources are used as efficiently as possible, we also know that, for many people, being at home with a terminal illness is a better experience for them and their families. We believe that more people could and should be supported to die outside of hospital.

We also know that the pressure on the NHS is set to increase as we see more people living with multiple long-term conditions and a rise in the number of people dying. Therefore, the Government needs to ensure that more people with a terminal illness are cared for where they want to receive that care. To do this, it will be necessary to provide mandatory and ongoing training to healthcare professionals to recognise and refer the 92,000 people currently missing out on palliative care in England to the care and support that they need in the community so that they can stay at home.

It is also important to highlight the role that social care can play in supporting people with a terminal illness. We would like to see the Government taking steps speed up access to social care for people with a terminal illness. We know that many people can be waiting for up to 30 days or longer, making it difficult for them to get home from hospital.

We believe that providing community care is right for the NHS and for people with a terminal illness. However, given the scale of demographic change, it is important that the Government and NHS Trusts across England focus on improving capacity of and access to community care services.

It is important to ensure that the NHS provides the best value for money where possible. However, this increased value must also benefit people, and supporting more people with a terminal illness to die where they want to can achieve both of those aims.