NHS use the economic crisis as an excuse to commit genocide

The bill for dying: One patient’s hospital treatment costs NHS more than £7,500 in final year of life

Total cost of looking after dying patients nearly £5 billion a year – with two thirds of the bill to the NHS
Almost half of all hospital costs were incurred by emergency inpatient admissions

By Steve Doughty
PUBLISHED: 03:43, 16 October 2012 | UPDATED: 09:01, 16 October 2012

Dying patients who need hospital treatment in England cost the NHS an average of £7,415 each, a research report said yesterday.

The bill covers care over the patient’s last year of life, and most of it is spent on emergency admission to hospital and then treatment in the final month, it found.

The report by independent research group the Nuffield Trust put the total cost to hospitals and social services of looking after dying patients at just under £5 billion a year, with nearly two thirds of the bill falling to the NHS.

It said the finding raised the question of whether it would be cheaper for people to die outside hospital, adding ‘now more than ever this type of analysis is critical if more value is to be extracted from public funds.’

The inquiry comes at a time of growing controversy over the way hospitals routinely withdraw treatment from patients judged to be dying and allegations that the cost of caring for very seriously ill patents is one of the reasons why.

NHS hospitals have adopted methods such as the Liverpool Care Pathway that are meant to ease the suffering of the dying during their last hours of life. But families have complained that LCP has been applied to patients who were not dying.

One senior NHS consultant, Professor Patrick Pullicino, has said that predicting death in advance is not medically possible, that the Pathway has become a ‘self-fulfilling prophecy’, and that it is being used to free hospital beds or deal with difficult patients.

The criticism suggests that the cost of treatment and care has become a factor in determining the way hospitals deal with the most severely ill and vulnerable patients.

The Nuffield report, called Understanding Patterns of Health and Social Care at the End of Life, said costs for hospitals were much higher than for local councils because many more of the dying use hospitals than social care.

Nearly nine out of 10 people in their last months of life go into hospital, but few more than a quarter use social care services.

Overall, nearly two thirds of the total bill for caring for the dying is met by hospitals.

But the report said that for each individual the cost of care of the dying in hospital was less than 60 per cent of the bill for local councils for social care of people in their last year of life, which covers both people in residential care homes and those who are given help to live in their own homes.

Those who get social care in their last year of life on average cost the taxpayer £12,559, the report said.

The costs are mainly spent helping people with low incomes because the care means test system means the better off have to pay their own care and care home bills, usually out of the value of their homes.

The report said that extra spending on social care – for example by easing the means test system so homeowners are required to spend less of their assets on a care home place – could save hospitals money.

Nuffield research head Dr Martin Bardsley said: ‘People are very vulnerable in the last months of their lives, and achieving appropriate and well-co-ordinated care across health and social care is critical. Our study suggests how social care might be effectively substituting for hospital care for this group of people.

He warned that the Coalition and local authorities should not cut back on social care spending. ‘The worry is that if funding for social care is cut back, people may have no option but to use hospital care. This may not be the best care for people who wish to be at home in their last months of life, as well as cost far more for the NHS.

‘Given the financial climate, this type of analysis is critical now more than ever if more value for patients is to be extracted from public funds.’ The report, based on the care of 73,243 people in seven English cities, said that £486.6 million was spent on their hospital care and £255.3 million on their social care.

‘Many more people used hospital care than social care in the last year of life, and total hospital costs in this period were approximately double those of social care services,’ it said.

Nearly half of all hospital costs were incurred by emergency inpatient admissions, and more than £2,000 of the cost of a hospital death was built up in the last month of life.

‘With this very large rise in activity towards the very end of life, over half of all hospital costs were due to activity in the last three months of life,’ the report said.

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