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A&Es under pressure from tens of thousands of dying people

New data from the NHS shows that tens of thousands of dying people are being rushed back and forth to A&E in the final days of their lives.

In 2017, over 26,000 people across England had three or more trips to A&E in their last 90 days.[1] Multiple unplanned emergency admissions to hospital are distressing for patients and place strain on overcrowded A&E departments.

The uncovering of the data by the terminal illness charity Marie Curie comes as the latest figures show A&E waiting times are at their highest level for 15 years.[2] New figures for February 2019 are due to be published on Thursday 14 March.

NHS data previously obtained by the charity showed that people in the last year of life were admitted to hospital 1.5 million times in 2016. This amounted to nearly nine million days in hospital, costing the NHS in England £2 billion.[3]

Investing in care for people at home and in the community is proven to reduce the number of emergency admissions to hospital at the end of life. Independent research from the Nuffield Trust found that people supported by the Marie Curie Nursing Service are much less likely to require an emergency admission to hospital and far more likely to die at home.[4]

Paul Brooks’ mother, Joan, died in hospital in May 2018, at the age of 98. She had been diagnosed with heart and kidney failure. In the last month of her life, she was admitted to hospital three times by ambulance. She lived alone in sheltered accommodation.

Paul said: “She was in hospital on and off for about a month. There was a lot of firefighting – treating her when she was admitted.”

“Mum was very anxious. Understandably, in the middle of the night if she was finding it hard to breathe, she called us and an ambulance. Sometimes by the time the ambulance arrived, I had managed to calm her down a little.”

Paul’s wife Lynn: “I called it the yo-yo effect – she was taken to hospital by ambulance, discharged home, then again admitted to hospital. We knew even when we were taking her home, that she would be back there again.”

“If we’d had a district nurse and someone to support her medically at home, then I think the emergency admissions could have been avoided. Getting up in the middle of the night and we knew it was going to happen again, you felt it was inevitable.”

Scott Sinclair, Head of Policy and Public Affairs, Marie Curie, said: “These figures show that sadly, many dying people spend their final days being rushed to and from hospital in the back of an ambulance, when they could be being cared for at home or in the community. We were pleased that the government committed to reducing end of life emergency admissions as part of the new NHS long term plan, and look forward to working with local NHS leaders to deliver on this commitment.”

[1] Measure 105c: www.england.nhs.uk/publication/ccg-iaf-data-extract

[2] www.dailymail.co.uk/wires/pa/article-6704315/Accident-emergency-waits-worst-level-15-years.html

[3] www.mariecurie.org.uk/media/press-releases/emergency-admissions-at-end-of-life-set-to-sky-rocket/183451

[4] www.nuffieldtrust.org.uk/news-item/further-evidence-on-the-cost-of-end-of-life-care-outside-of-hospital-new-nuffield-trust-analysis

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