Home death can save NHS millions says Marie Curie

Marie Curie estimates that savings of £34 million could be achieved by reducing the hospital stay of 30,000 patients (approximately 12% of those who currently die in hospital in England each year), by just four days.

Marie Curie, the leading end of life care charity, has published a briefing which summarises evidence on the scale of NHS savings that could be achieved. You can download our report - 'Understanding the cost of end life care in different settings'.

At present, the most deaths happen in hospital (53%)¹. In England in 2010 this equated to 245,570 deaths in hospital. This is the place people say they would least want to be at the end of life², and a care setting that is also very costly to the NHS. Inpatient specialist palliative care costs the NHS £425 per day³. For people at the end of life, hospital stays are often lengthy, with 40% lasting over a week⁴.

Imelda Redmond CBE, Director of Policy and Public Affairs at Marie Curie Cancer Care said:
“The NHS has to save £20 billion by 2015. Savings on the scale required can only be achieved through service redesign that can be rapidly implemented across the NHS. Ensuring that more people who are terminally ill are able to be cared for and die at home can release funds. Even small reductions in the number of days people at the end of life spend in hospital can lead to substantial savings. The National Audit Office⁵ found that a reduction of just 10% in emergency admissions and of three days in hospital stay could save the NHS £104 million. But we think we can help the NHS to achieve even more.”

Since 2004, Marie Curie Cancer Care’s service design specialists have been bringing together commissioners and providers from the public, independent, and voluntary sectors to ensure that more people at the end of life can be cared for and die at home.

Case studies 

Reducing acute admissions

Palliative and end of life care needs in rural Yorkshire. Marie Curie Nurses visit and provide telephone support to patients needing symptom control in rural areas of East Riding between 6pm and 11pm, seven days a week. The service also identifies people needing the Marie Curie night service at short notice, preventing emergency out of hours’ acute admissions. In a six-month period the service provided care for 183 patients.

Neil Griffiths, Assistant Director of Joint Commissioning, NHS East Riding said:
“We have a good relationship with Marie Curie and enjoy working with them. Their flexibility allows us to work constructively together to change the way services are delivered. Marie Curie’s reputation counts for a lot with patients and families. Caring for someone at home who may be in pain is an emotional strain for carers. Knowing that they will be supported by nurses who work specifically in palliative care makes a huge difference.”

Rapid response

Reducing avoidable acute admissions in North Wales Integrated with the out-of-hours teams, Marie Curie’s rapid response service provides the people of Conwy, Denbighshire, Flintshire and Wrexham with access to a 24-hour palliative care service. Marie Curie Nurses provide urgent symptom control and psychological and social support to people needing end of life care at home or in care homes. Over 600 admissions have been avoided so far, saving an estimated £1.4million.

ENDS

References

^{1. End of Life Care Strategy, Third Annual Report, Department of Health 2011↩}

^{2. Local preferences and place of death in regions within England, Barbara Gomes, Natalia Calanzani and Irene J Higginson 2010↩}

^{3. Unit costs of Health and Social Care, University of Kent 2010↩}

^{4. Data from the National Institute for Health and Clinical Excellence (NICE) Commissioning and Benchmarking tool, published December 2011 http://www.nice.org.uk/cmg42↩}

^{5. The potential cost savings of greater use of home and hospice based end of life care in England, prepared for the National Audit Office, Published by the RAND Corporation, 2008 More case studies and details of Marie Curie Cancer Care’s partnership working can be found in We know about end of life care in the publications section of: http://www.mariecurie.org.uk/commissioning↩}