‘Terminal patients too long in 999 ward beds’
PATIENTS in the last year of their lives are spending too much time in emergency hospital settings – and the situation could hit “crisis point” if care in the community is not significantly improved.
That’s according to terminal illness charity Marie Curie, which claims “unnecessary” hospital admissions are costing the Welsh NHS millions every year.
New data collected by the charity has revealed there were more than 51,000 emergency admissions for people in the last year of their life in Wales in 2016, costing the NHS £194m and amounting to around 872,000 days in hospital.
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 – significantly 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 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 additional £154m.
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.
“While 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 more challenging.
“As our analysis shows a relatively minor change to the 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.”
Marie Curie’s analysis of the data shows in Wales average days spent in hospital following emergency admissions in the 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.
Research by the Nuffield Trust has shown hospital costs are by far the largest cost involved in end-of-life care and that potential savings might be made if community-based support were made more widely available.