Unnecessary hospital admissions for terminally ill costing the NHS – report

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More must be done to stop terminally-ill people having unnecessary emergency admissions to hospital, a charity has said.

Marie Curie said emergency admissions for people in their last year of life can often be avoided if there is appropriate support in the community.

The charity found that in 2016 there were nearly 100,000 emergency admissions for people in the last year of their life, costing NHS Scotland £285 million and amounting to more than one million days in hospital.

Across the UK, there were more than 1.6 million emergency admissions for people in the last year of their life. The figures exclude sudden deaths involving cases such as car crashes.

Marie Curie said there has been a decline over the last five years in the number of emergency beds used by dying people but even if the trend continues to lower more A&E services would still be needed.

The Scottish Government wants everyone who needs palliative care to have access to it by 2021, with a doubling of services.

Richard Meade, head of policy and public affairs Scotland at Marie Curie, 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 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.

“Being rushed repeatedly to hospital is stressful and upsetting, particularly when someone may have little time left.

“A&E should be a last resort, not the first port of call for care. It makes an already difficult time much worse.

“The integration of health and social care gives us a fighting chance to improve care in the community. If the Scottish Government realises its ambition that everyone who needs palliative care has access to it by 2021, including a doubling of community palliative care services, then this will help to continue to ease the pressure on hospitals and acute settings now and in the future.”

Research by the Nuffield Trust has shown that hospital costs are by far the largest cost involved in end-of-life care.

A Scottish Government spokeswoman said: “Scotland is widely recognised for providing high quality palliative care for those nearing the end of their life. Through our Framework for Action on Palliative and End of Life Care, we want to make sure that everyone who needs it receives high quality palliative care, tailored to their needs, in hospital or in the community.

“The Marie Curie report notes that we have responded to the demands of an aging population on health and care services through the  integration of health and social care.

“This reform seeks to ensure that those who use services get the right care and support whatever their needs, at any point in their care journey, and will enable more people to be supported in the community at the end of life.”

Dr Adrian Boyle, chair of the quality emergency care committee at the Royal College of Emergency Medicine, said: “The last thing patients at the end of their lives want is to be in hospital.

“Increasing the resources available to social care will not only help reduce avoidable admissions, free up beds and relieve pressure on our struggling emergency departments, but will afford terminal patients the dignity and comfort of living out their last days in familiar surroundings.”

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