Charities say letting people die at home could save millions for NHS

The Press Association reports in the Guardian 27th April 2015: Charities say letting people die at home could save millions for NHS Marie Curie says many people with a terminal illness are in hospital unnecessarily, and not by choice, at the end of their lives 

In the richer areas and more densely populated areas of the country hospices are well funded. They will therefore continue, and the health divide between the rich and the poor will be enhanced… the suggestion makes good sense, but if funding is not given disproportionately it could be regressive. It is however, an example of rational rationing of resources. It will not save a lot f money but could free up plenty of beds…

The NHS could save millions of pounds if the majority of people who died of a terminal illness in hospital did so at home as most wished to do, charities have said.

Figures from the latest Office for National Statistics (ONS) survey of bereaved people found that 85% of those who died in hospital in 2013 had expressed a desire to die at home.

Marie Curie, which provides care and support to people with terminal illness, said patients were being denied the choice because of factors including a lack of 24/7 community support, poor coordination between services and the failure to provide fast and free social care support for people at the end of life.

But the charity said there was scope for efficiency savings to be made by helping those who wanted to spend their final days at home to do so.

With access to high-quality nursing care in the community, total care costs could be as much as £500 lower per person.

All the main political parties have made some kind of commitment to improve choice at the end of life, but Marie Curie – representing a coalition of other charities – said whichever party came into power in the next parliament needed to set out how it would do this.

Dr Jane Collins, chief executive of Marie Curie, said: “It’s time to change the way we care for people with a terminal illness.

“Fewer than 5% of people say they want to be in hospital at the end of their lives, yet around 50% of people who die do so in hospital, often with no clinical need to be there.

“Pressure is increasing on NHS budgets and A&E departments are already over-stretched.

“The evidence shows that it makes financial sense for the NHS to support people to be cared for at home in their last weeks and days. This is also what the majority of people with a terminal illness would prefer.

“Together, we are calling on all parties and the next government to set out how they will introduce fast and free social care for everyone nearing the end of their lives to reduce pressure on hospitals and deliver genuine choice.”

Marie Curie has been working with charities that support people at the end of their lives. These are Cicely Saunders International, Hospice UK, Macmillan Cancer Support, the Motor Neurone Disease Association, the National Council for Palliative Care and Sue Ryder.

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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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