How community care can help relieve our hospital crisis

Rick Wright, Marie Curie's Policy Manager, explains why reducing unnecessary emergency admissions to hospital is vital to relieving the current pressure on the NHS. 

The NHS winter crisis is back with a vengeance. Emergency care in the NHS is facing unprecedented pressures and levels of concern, both from within the health service and from the public.

With hospitals across the UK experiencing bed occupancy rates of over 95%, far exceeding the recommended safe limit of 85%, something has to give.  

Part of the solution must lie in reducing unnecessary emergency admissions to hospital.

When support is lacking

People who are dying often experience disruptive repeat hospital visits in their final months, due in part to the complex nature of the care they require but also to the lack of the support they need outside of hospitals. 

As one of the largest providers of end of life care in the UK through our nursing service and hospices, this is something we at Marie Curie hear time and again from the families we support.

The best option?

Rushing someone to hospital can be the right course of action. Sometimes the care people need can only be provided in a hospital.

However, we know that many people in hospital could be being treated at home or in the community perfectly well with the proper resources in place; many of their most common symptoms such as breathlessness or pain can be effectively treated in the community if the right support is available. 

Improving people's experience 

It’s also generally better for the patient. Every time someone approaching the end of their life is rushed into hospital it can result in upset and disruption for them which impacts on their quality of life.

They also often have to endure the stress and uncertainty of not knowing when or even if they will be able to return home.

The impact of community care

Failure to provide these essential end of life care services with the capacity and expertise to operate effectively in communities has a direct impact on NHS hospitals.

The evidence shows us that community palliative care services can be highly successful in reducing emergency admissions. For example, independent research from the Nuffield Trust found that the Marie Curie Nursing Service reduced the likelihood of people requiring emergency admissions from 29% to 12%.[1]

Our nurses can provide care in the community at any time, day or night, meaning that people are still able to access expert care outside of standard business hours and outside of hospital.

This means that when less specialised health professionals do not feel prepared to treat a terminally ill person at home, they are able to call in a Marie Curie Nurse rather than an ambulance. 

An issue that can't wait 

But we provide only part of the answer. Well-resourced social care which can respond quickly together with NHS services in the community is an even bigger part.

The need for greater investment in, and planning of, care and support in the community is becoming critical.

Without that, simple demographics (an ageing population, with more people living longer, more people living with complex conditions and more people dying each year) mean these problems will only get worse.

And if that happens, the winter crisis could become business as usual. 



[1] Chitnis X, Georghiou T, Steventon A and Bardsley M (2012), The impact of the Marie Curie Nursing Service on place of death and hospital use at the end of life, The Nuffield Trust.