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Can Giving Patients Choice Be Cost-Effective for the NHS?

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With the number of deaths set to increase by 17% to 590,000 by 2030, we are facing a ticking time bomb when it comes to end of life care. A rapidly ageing population and increases in the number of people with complex long-term conditions will lead to greater demands on providers of end of life care and rocketing costs for the NHS predicted to rise from £20billion to £25billion by 2030. This issue is the subject of a series of fringe events Patient Choice V Care being held by Marie Curie is partnership with Sue Ryder and Help the Hospices, during the political party conference season.

Marie Curie believes politicians from all parties must start to take a longer term view when it comes to end of life care. We are urging all parties to invest in end of life care improvements across a range of settings, including hospices, at home, hospitals and in care homes. A key way to facilitate this could be through encouraging stronger partnerships between hospitals and hospices, in order to help improve hospital care, along with increasing the range of care available in community settings including at home.

We know that 63% of people want to die at home compared to just 8% in a hospital but the reality is that the majority of people - almost 55% are dying in hospitals. Making it possible for more people to die at home, or in hospices, could lead to greater efficiency and potential cost savings for the NHS.

We want all political parties to commit in their manifestos to everyone in the UK having a good death involving access to social care and 24/7 palliative care, good pain management, quality advice and information and support for families and carers.

Marie Curie's Death and Dying report shows that 40% of people who die in hospital have no medical need to be there. Terminally ill people with no clinical need to be in hospital, find it hard to get home, into a care home, or a hospice. This can be because they are unable to get a social care package to support them put in place swiftly, with many waiting for up to 30 days for their application to be processed. For others, there's a lack of availability of palliative care services in the community 24 hours a day, seven days a week.

Many people still don't have the opportunity to register their preference for where they are cared for and die. The National Bereavement Survey - VOICES found that only 32% of people who had died from a terminal illness were aware that they were going to die and less than half of patients (44%) had expressed a choice.

Better identification of people who are in the last days and weeks of life, increased provision of community-based services and greater integration of hospital and community-based services are essential to help reduce the pressures on the NHS and increase choices and services for people at the end of life.

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