Understanding the cost of end of life care in different settings

Source: Marie Curie  

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Date of publication: February 2012

Publication type: Report

In a nutshell: This report from Marie Curie’s considers the economic impact of providing care to patients in the community, rather than in the acute setting and presents a clear argument for the development of high-quality community-based care.  Marie Curie estimate:

• community care at the end of life costs £145 per day
• specialist palliative in-patient care costs £425 per day
• changing the setting of care could reduce daily costs by £280.
• between 355,000 and 457,000 patients need palliative care annually.
• If community services were developed to enable just 30,000 patients to reduce their hospital stay by just four days, there could be a saving of £34 million.

Length of publication: 8 pages

Comparing the costs of alternative models of end-of-life care

Title: Comparing the costs of alternative models of end-of-life care

Source: Journal of Palliative Care 2011 Summer; 27(2), p126-33

Follow this link for article abstract

Date of publication: Summer 2011

Publication type: Article

In a nutshell: This study explores the financial consequences of decreased acute care utilisation and expanded community-based care for patients at the end of life in England. Results suggest that reducing reliance on acute care could release resources and better meet peoples’ preferences.

Length of publication: 8 pages

Acknowledgements: Pubmed

Contact your local health library to obtain a copy of this article. Follow this link to find your local health library.

End of Life Care Locality Registers evaluation: final report

Source: National End of Life Care Programme

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Date of publication: June 2011

Publication type: Report

In a nutshell: Published by Ipsos MORI this report presents the findings from an evaluation of eight locality register pilot sites across England which began operating in October 2009.  

Length of publication: 169 pages

Dying well matters: one Wales 3 years on. 2008-2011

Source:  Welsh Assembly Government 

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Date of publication: March 2011

Publication type:  Report

In a nutshell:   This report highlights the progress of the work of the Palliative Care Implementation board in Wales over a 3 year period.  Progress includes:

• Wales-wide full-time access to specialist palliative care 
• adequate funding for hospices providing specialist palliative care on behalf of the NHS
• provision of training within primary care teams focussing on clinical skills and referrals
• development of  an electronic patient information system
• systematic capture of patients’ feedback which is used to improve services.

2010-11  ringfenced funding of £6.888 million will be maintained for 2011-12.

Length of publication: 33 pages

 Acknowledgement: National End of Life Care Programme website.

NCPC and Help the Hospices Funding Survey 2010

Source: National Council for Palliative Care

Follow this link for a summary

Date of publication: December 2010

Publication type: Report

In a nutshell: In October 2010, NCPC and Help the Hospices surveyed adult palliative care providers to see what their current funding situation was and how much the wider financial climate was impacting on them.

In 2010/11, £150M of revenue funding is due to be distributed to support the implementation of the End of Life Care Strategy (England). Despite this, the survey found:

• A third of all respondents were aware of care staff cuts in local palliative and end of life care services.
• Nearly 30% of hospices (voluntary sector and NHS) have already had their statutory funding cut in the current year.
• 30% of all respondents anticipate a decrease in their statutory funding in 2011/12.

Length of publication: 4 pages

Acknowledgement: National Council for Palliative Care

Social care and hospital use at the end of life

Source:  The Nuffield Trust

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Date of publication:  December 2010

Publication type:  Report

In a nutshell:  This report shows the finding of research conducted by the Nuffield Trust into the use and estimated costs of hospital and social care services for large groups of individuals at the end of their lives.  Key findings indicate:

• An average of 30 per cent of the people who died used some form of local authority-funded social care service in the 12 months prior to death.
• Local authority-funded social care increased gradually in the last year of life, whereas NHS-funded inpatient hospital care increased sharply.
• The balance of total hospital inpatient and social care costs shifted dramatically with increasing age.

Further research involving a larger population has been commissioned by the National End of Life Care Intelligence Network.

Length of publication:  34 pages

Palliative Care Funding Review – Interim Report 2010

Source: National End of Life Care Programme

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Date of publication: December 2010

Publication type: Report

In a nutshell:  This is an interim report from the Palliative Care Funding Review chaired by the Chief Executive of Marie Curie Cancer Care, Tom Hughes-Hallett who has been tasked to conduct an independent review to recommend a funding system to ensure provision of dedicated palliative care in England.  This interim report addresses: building on best practice to improve outcomes for people; defining dedicated palliative care; the funding mechanism challenge; the way forward.

Length of publication: 32 pages

Acknowledgement: National End of Life Care Programme

Implementing the End of Life Care Strategy

Source: The King’s Fund

Follow this link for fulltext (just click on the PDF icon for free online access)

Date of publication: October 2010

Publication type: 

In a nutshell:  This report is based on evidence from The King’s Fund’s evaluation of the Marie Curie Delivering Choice Programme.  It highlights examples of good practice and learning for the organisation and delivery of end-of-life care across England and provides guidance on the delivery options and ongoing challenges in the organisation of end-of-life care that can be implemented or adapted locally. The report is likely to be of interest to commissioners, service leads and those staff involved in the quality, innovation, productivity and prevention (QIPP) agenda.

Length of publication: 14 pages

Acknowledgement:

End-of-life care in hospital: a descriptive study of all inpatient deaths in 1 year.

Source: Palliative Medicine,  2009,. 23(7) p.616-622

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Date of publication: October 2009

Publication type: article

In a nutshell: The article describes a hospital based study in England covering a one-year period with the following objectives:

• to ascertain how many hospital deaths could have occurred at home
• to obtain the cost of each inpatient stay
• to estimate the maximum resource implications of care packages
• to calculate the financial savings possible that could be used for community-based services.

The findings indicate that a maximum of one third of all the deaths examined could occurred at home and shows that when commissioning end of life care services, it is possible to calculate how many extra patients may need community care packages as opposed to hospital care, and the associated costs that could be redistributed from hospital to community for these services. 

Length of publication: 7 pages

Some important notes:  If you do not have an NHS Athens password please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library. 

Acknowledgement: Medline 

National End of Life Care Intelligence Network launched

Title: National End of Life Care Intelligence Network launched

Source: National End of Life Care Intelligence Network

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Publication type: Website

In a nutshell: The National End of Life Care Intelligence Network (NEoLCIN) aims to improve the collection and analysis of information related to the quality, volume and costs of care provided by the NHS, social services and the third sector, to people approaching the end of life. This intelligence will help drive improvements in the quality and productivity of services. The Network is supported by the National End of Life Care Programme.

Justifying terminal care by ‘retrospective quality-adjusted life-years’

Title: Justifying terminal care by ‘retrospective quality-adjusted life-years’

Source: Journal of Medical Ethics 2010(36), p290-292

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Date of Publication: May 2010

In a nutshell: QALYs are a crude tool used in terms of the number of quality-adjusted life-years a medical procedure will provide, however they cannot justify spending any money on terminal care (and indeed on older people in general). This paper suggests a different way of construing ‘quality’ (as meaningfulness rather than physical comfort) and ‘life’ (as both backward-looking and forward-looking), so that the terminal patient’s efforts to find meaning in his life could in principle generate plenty of ‘retrospective QALYs’ to justify funding.

Length of Publication: 2 pages

Some important notes: This article is available online using an NHS Athens password. To register for an NHS Athens password follow this link, alternatively contact your local health library for a copy of this article.

Following The Money: Findings from the NCPC’s survey to monitor the year of investment in end of life care 2009/10

Title: Following The Money: Findings from the NCPC’s survey to monitor the year of investment in end of life care 2009/10

Source: National Council for Palliative Care

Follow the link for NCPC Publications

Date of Publication: March 2010

Publication Type: Briefing

In a nutshell: Briefing 18 reports the findings of NCPC’s survey of SHAs, PCT commissioners and palliative care providers to find out whether commissioners and providers could account for the additional funds and whether they were reaching frontline services.
Length of Publication: 4 pages

Some important notes: Please contact your local health library for a copy of this briefing report.

MPs call for better checks on how PCTs spend dementia strategy money

Title: MPs call for better checks on how PCTs spend dementia strategy money

Source: Alzheimer’s Society

Follow this link for the web article

Date of publication: March 2010

In a nutshell: The All Party Parliamentary Group (APPG) for dementia has called for dementia strategy funding to be better monitored and audited in light of the information that more than two thirds of PCTs are unable to say if or how they have spent funds allocated to them under the National Dementia Strategy for England.

Length of publication: 1 page

Better Investment: Better Dying – Conference: London 24 February 2010

Source: National End of Life Care Programme

Follow this link to conference programme

Date: December 2009

Publication Type: Website

In a nutshell: Better Investment: Better Dying – Progress with Measurement and Collaborative Commissioning for End of Life Care Conference is an opportunity to explore the progress with measurement and collaborative commissioning of end of life care services. The conference aims to:

• Provide an opportunity to hear from some of the leaders and experts in collaborativecommissioning, measurement and end of life care
• Explore the importance of measurement and benchmarking from both commissionerand provider perspectives
• Present some of the latest good practice through interactive masterclasses and panel discussion and enable delegates to explore their priority areas
• Present the results of the NCPC Survey on Funding for End of Life Care

Acknowledgement: National End of Life Care Programme