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Community-based end of life care could save £100m

29 February 2016

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Reducing hospital-based end of life care could improve patient choice and save more than £100 million, a new report has estimated.

If half of those who died in 2014 were given access to a service in the community that facilitates choice, an estimated over £100 million could be saved, according to On The Brink, a report from charities united as The End of Life Care Coalition.

Hospital care in the final three months of life is estimated to cost an average of £4,500 per person who dies and the costs of care increase rapidly in the last weeks of life.

This new report comes after the government-commissioned the Choice Review on end of life care – released in 2014. This set out a comprehensive vision showing how end of life care services need to be reformed to give people greater choice and higher quality care at end of life.

The key recommendations include establishing 24/7 end of life care outside of hospital in all areas by 2019, greater joint working, a named care coordinator, and implementing shared electronic end of life care records by April 2018 in all areas.

An example of good integration was explained in On the Brink, as one patient states: “Our son’s discharge was clearly the result of fully integrated consultation and co-operation conducted in the 16 hours between 4.30pm on one day and 8.30am on the next… as a result of [the Macmillan nurse] coordinating his discharge and support, Neil had a good death and our memories of his final hours are much more positive than they would have been had he died in hospital.”

The report also calls for:

·      A higher proportion of the medical research budget dedicated to developing better ways of caring for terminally ill people and their families; currently it stands at just 0.1 per cent, or 10p in every £100.12.

·      Fully co-ordinated and integrated care across all teams and services supporting a person at the end of their life, including fair access to social care, using appropriate care plans in a joined-up way.

·      Training for all health care professionals, so they know how to support someone approaching the end of their life confidently and sensitively.

·      Investment in palliative care specialists and generalist health and social care professionals with the knowledge, understanding and time to deliver choice and provide high quality care.

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