Rich-poor divide over cancer care
Vulnerable cancer patients are being let down by “significant disparities” in end of life care between the country’s richest and poorest areas, new research has found.
Those with the four most common cancers in deprived parts of England are more likely than those in more affluent areas to need emergency care.
VULNERABLE CANCER patients are being let down by “significant disparities” in end of life care between the country’s richest and poorest areas, new research has found.
Those with the four most common cancers living in deprived parts of England are more likely than those in more affluent areas to need emergency care in the last six months of their life.
The study could highlight “unacceptable” variations in access to specialist end of life care, charity Macmillan Cancer Support has warned, adding that it comes at a cost of £4.6m to the NHS.
“Access to the right care and support at the end of your life shouldn’t depend on where you live,” said Paul McCavana, head of Macmillan for the North.
“Too many people from the parts of the country are having to access emergency care rather than good quality care in a planned way. As well as the great human cost, there’s a great financial cost to this as well.
“We have some good examples of quality care in Yorkshire, but the research tells us that those living in deprived areas don’t have that access. It’s traumatic for patients and their families. Emergency care is for people who have emergencies. When you’re at the end of your life, it’s not the way you want to be cared for.”
The study, funded by Macmillan and carried out by City, University of London and the Economic and Social Research Institute, analysed data from England’s National Cancer Registry on 250,000 people.
It found that those with breast, bowel, prostate, and lung cancer, living in the most deprived parts of England are more likely to be admitted to hospital as an emergency in the last six months of their lives.
It also found that cancer patients from the most deprived areas spend longer in hospital following an emergency admission.
Compared with people from the wealthiest areas, patients from the poorest areas with bowel cancer spend four more days in hospital, while women with breast cancer spend three additional days in hospital. People from the most deprived regions with lung cancer spend an average of two more days in hospital. The researchers calculated the extra cost of care for people in the most deprived areas costs the NHS an extra £4.6m a year for these cancers alone.
“What our study shows is that there are significant disparities in end-of-life hospital treatment costs for cancer patients in England, largely due to a greater use of emergency care in patients from most deprived areas,” said Dr Mauro Laudicella, senior lecturer in health economics at City, University of London.
“In contrast, use of elective care is more prevalent in patients from less deprived areas of England.
“Managing the health care needs of patients from most deprived areas more effectively could potentially reduce such disparities in costs, through the use of planned rather than emergency care, and a more effective use of palliative care. By investing in patients early on in their cancer journey, the NHS can slow down the spiralling cost of care, and ensure that in the future everyone who has cancer will be able to get the care they need.”
A Department of Health spokesman said: “Cancer survival is at a record high and we are fully committed to improving cancer outcomes and end-of-life care for everyone, regardless of where they live. Our strategy for achieving world class cancer outcomes includes a clear commitment to ensure earlier access to end-oflife care support.”