Challenge ahead to reduce pressure on Welsh hospital beds

Marie Curie says that too many people in Wales are still spending too long as an emergency hospital admission 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 51,000 emergency admissions for people in the last year of their life in Wales in 2016, costing the NHS £194 million and amounting to around  872,000 days in hospital. 

Marie Curie’s analysis of the data also shows that when someone in the last year of life is admitted as an emergency in Wales they spend on average a month (28 days) in hospital – more than England (18 days) or Scotland (23 days). 

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 people dying over the next 20 years means the cost of emergency admissions for people in the last year of life in Wales could cost the NHS an extra £154 million. 

Marie Curie’s analysis of the data shows that in Wales, average days spent in hospital following emergency admissions in last year of life between 2011 and 2016 fell from 28.53 to 27.56.  Meanwhile, the average length of the stay per emergency admission in the last year of life fell from 17.72 to 17.13. 

If these figures continue to improve at their current rate, by 2041 we can expect Wales to reduce average days by more than a week.  However, people in the last year of their life in Wales will still be spending more days on average in an emergency bed in 2041 than people in England were in 2016. 

Further reduction in average days in hospital will require investment in community services  so, even if fewer hospital beds are required in future in Wales, this may not translate into significant cost savings.

 Simon Jones, Head of Policy and Public Affairs at Marie Curie Wales 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. 

“Whilst it looks like Wales is making very welcome reductions in the number of days someone spends in an emergency bed in their last year of life it is very important not to think this trend will continue without great effort. 

“Wales started with the highest number of days and as improvements are made keeping up the same pace will get ever more difficult and challenging. As our analysis shows a relatively minor change to the current trend will have a significant impact on the number of hospital beds that will be needed. 

“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.   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.