Healthcare system must adapt to rising pressures on emergency services

14th September 2018

Pressure on emergency services is increasing.  Researchers at the Cicely Saunders Institute have published research showing the number of emergency hospital admissions for people in their last year of life could increase by 85% to 2.8 million by 2041, placing significant strain on the National Health Service.

In a letter published in The Lancet researchers examined the impact of population ageing on end of life care in NHS hospital and community services.   They also analysed  emergency management of complex health needs and pressure on emergency services.

Due to greater life expectancy and an ageing population, the numbers of deaths are projected to rise to unprecedented levels by 2040, with an additional 130,000 people dying each year.  Over half of these deaths will be people aged 85 or over. Emergency hospital admissions of these older patients increases in the year before death. In 2016, one in four (over 1.5 million) of all emergency hospital admissions were for people in the last year of life.

This new research is supported by the charity Cicely Saunders International.  If admissions continue to rise at current rates, the number of hospital admissions each year will almost double, increasing by more than 1.3 million, to 2.8 million by 2041.

In England 48% of the population currently die in hospital, 23% at home and 21% in a care home. Projections based on the continuation of this trend mean that by 2040, the number of deaths outside hospital, in the community, could double.

Author Anna Bone from the Cicely Saunders Institute said: ‘Most people state that they prefer home-based or home-like care with access to out-of-hours care. Multiple trips to hospital in the months before death can be distressing for both patient and family, and is costly for the health system.

‘We need to adapt to this new era of patient and family needs, and find a sustainable way to provide quality care towards the end of life.  The system needs to respond quickly to meet needs and provide care where people want to be cared for.’

Read the full letter here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31823-3/fulltext