New research finds that 81% of total end-of-life healthcare spend goes on hospital care with only 15% spent on community and hospice care.
Public expenditure for people in the last year of life across healthcare, social care and social security has reached £22 billion of which more than half (53%) is on healthcare. This equates to £18,020 per person.
This is the chief finding of research from the Nuffield Trust and the Health Economics Unit, commissioned by leading end-of-life charity Marie Curie.
Hospital care represents the largest share of healthcare spending, accounting for 81% of total healthcare spend (£9.6 billion). More than half of this healthcare spend (56%) goes on emergency hospital care (£6.6 billion).
In contrast, public spending on primary and community healthcare makes up only 11% (£1.3 billion) of health expenditure for people in the last year of life, with less than 4% (£414 million) spent on hospice care.
The remainder is taken up by GP practice costs and out-of-hospital care.
“The UK government has pledged to move more care out of hospitals as part of its 10-Year Health Plan for the NHS in England. But with £4 in every £5 of health care spend for those in their last year of life going on hospital care, our findings show the government has a serious challenge ahead to make this a reality for those in need at the end of life,” said report co-author and Nuffield Trust deputy director of research Sarah Scobie.
Prioritise palliative care
Marie Curie says there is a significant lack of access to end-of-life care in communities, leaving people dying alone, without the care they want at home and too often forced towards emergency services, such as ambulances and A&E, and admitted to hospital for their final moments.
The end-of-life charity is calling for a transformation fund to invest in innovative community-driven ways of caring for those at the end of their lives to help reduce hospital expenditure in line with targets and ultimately improve access to care and support for dying people.
“There is only one chance to get end-of-life care right, and alongside increased support for community services, we’re calling on the government to deliver a sustainable, long-term funding plan, that includes ways to future-proof the workforce, so that wherever you live, whatever your illness, you’ll be able to rely on good care right to the end,” said Sam Royston, executive director of research and policy at Marie Curie.
“All UK governments must prioritise palliative care to ease the strain on the overburdened and underfunded NHS and create a system that works for everyone,” he continued.
