Increased use of inpatient specialist palliative care services in England
A PHE-commissioned report shows an increase in the availability and use of inpatient specialist palliative care beds in England.
The report, published by the National Council for Palliative Care (NCPC) and Public Health England’s National End of Life Care Intelligence Network, shows that the mean number of patients seen in inpatient units is at its highest level in more than 10 years, with the average number of available beds (those that are or can be used) also at a high. The proportion of occupied beds has also remained high at 74.8%, reflecting efficient use of beds, although there are considerable variations across the country.
The report also finds that people receiving specialist palliative care are more likely to be able to die at home – the place where most people say that want to die. Nearly half of people (45%) referred to a specialist palliative care inpatient service are discharged to their home, further dispelling the myth that people only go into a hospice to die. Nearly half the people receiving specialist palliative care in the community (49.8%) died in their home and less than a quarter (23.9%) died in hospital. This compares with ONS data for all deaths, which shows that 21.8% died at home and 51.5% in hospital.
The report also shows that specialist palliative care services have made considerable progress in opening up to non-cancer patients, but that there remains a long way to go. The most striking increases have been in hospital support and outpatient services, where non-cancer diagnoses now account for one fifth of all diagnoses.
Day and community care also show a steady increase of supporting people with non-cancer diagnoses. In specialist palliative care inpatient units, the proportion of patients with a non-cancer diagnosis has increased: from 3% in year 1997 to 1998, to 11% in year 2011 to 2012.
The report is an update to the annual national survey of patient activity data for specialist palliative care services minimum data set. It looks at a wide range of specialist palliative care issues, including inpatient activity, day care, community care, hospital support, bereavement support, outpatients, staffing, diagnoses and services for young people.