The impact of the Marie Curie Nursing Service: new evidence

by Michael Cooke
Head of Analytics, Caring Services

Download the executive summary

The Marie Curie Nursing Service provides care to a large number of patients at the end of life across the UK – over 27,000 each year. This scale gives us a unique resource: vast quantities of data about the care delivered to terminally ill people at home. However, even this is dwarfed by the epic scale of the data that the NHS holds about every episode of care delivered in every hospital in England (the Hospital Episode Statistics database), and the records collated by the Office for National Statistics on when, where and of what cause people die in England and Wales.

In isolation, each source tells us something interesting about end of life care, from patterns of nursing services usage, through to how long people spend in hospital before they die, and the relationship between where people die and what they die from. But the whole can be so much more than the sum of its parts, and that’s where the Nuffield Trust come in. They are experts in linking together these data sources to see an individual’s pathway through care services, while protecting patient anonymity.

Marie Curie commissioned the Nuffield Trust to use their data linkage expertise to evaluate the impact of our nursing service on where people die and how much hospital care they receive. They used the three data sources outlined above to produce a combined picture of the care delivered to over 29,000 of our patients. The really clever part was that they used the information about each patient to identify a matched ‘control patient’ who was similar in every way they could measure, other than the fact that they were not a Marie Curie patient. They were then able to look at how the outcomes of the two groups differed – this is about as fair a comparison as is possible without doing a clinical trial.

This independent research, which was published today, provides hard evidence that patients cared for by our Nursing Service are more likely to die at home, and are less likely end up in hospital. Beneath these headlines are a range of interesting analyses (such as comparing outcomes for patients with cancer to those with other diagnosis) which are only possible to explore because we provide care to so many patients each year.