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Health system must adapt to rising numbers of deaths and pressures on emergency services

Research from the Cicely Saunders Institute has found by 2041 the number of emergency hospital admissions for people in their last year of life could increase by 85% to 2.8 million, placing significant strain on the NHS.

In a letter published in The Lancet, academics from the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, examined the impact of population ageing on end of life care in NHS hospital and community 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 which will be people aged 85 or over. The number of 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 was from people in the last year of life. 

This new research, supported by the charity Cicely Saunders International,  calculates that if the average numbers of admissions continues 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.

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

Speaking about the research, author Anna Bone said: ‘Most people state that they prefer home-based care and access to out-of-hours care towards the end of life. Multiple trips to hospital in the months before death can be distressing for both the patient and their 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, that responds quickly, meets needs and provides care where people want to be cared for.’


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