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Growing demand for end of life care will put ‘intolerable’ strain on health and social care

27 April 2016

Macmillan Cancer Support is today warning that the NHS and social services will not be able to cope with an increase in the number of people dying from cancer.

Macmillan estimates that by 2020 nearly 144,000 people will die from cancer each year – an increase of 15,000 when compared to 2010.

There is already evidence that not everyone receives high quality care at the end of life, as highlighted last week by the latest ONS survey of bereaved relatives.

As well as poor care, both Macmillan and the ONS data highlight that a majority of people do no get to spend their final days where they wish.

Macmillan warns that, as more people are diagnosed with cancer and the country’s population grows and ages, this situation could get worse – if immediate action is not taken.

Macmillan predicts that if government does not act to improve the situation, nearly 65,000 people dying of cancer will experience poor care in their last three months of life over the next five years.

The charity is calling on the government to invest in services such as out of hours community services for people at the end of their life – as recommended in an independent review of choice at the end of life published last year.

"It is unacceptable for a person dying of cancer to have to go to hospital when they don’t want to be there, because care and support wasn’t available at home,” said Lynda Thomas, chief executive of Macmillan.

“If the government really wants to improve end of life care for everybody, then investment is vital. If nothing is done and the country’s deeply imperfect arrangements continue, then end of life care is heading for a meltdown.

“That is why the government must fully fund the recommendations put forward in last year’s independent review of choice at the end of life, such as a shared record of people’s preferences at the end of life.

“Without action now, thousands of people with cancer will not have the high quality, compassionate end of life care that everybody should experience.”

"Everyone must be able to receive high quality care, whatever their diagnosis"

While the figures released today by Macmillan focus on those who are dying from cancer, the demand for palliative and end of life care is even greater when you take into account those who die from other causes – as Simon Chapman, director of policy and external affairs for the National Council for Palliative Care (NCPC), points out:

"Although the majority of people die from conditions other than cancer, people with cancer are more likely to be able to access palliative and end of life care than others. Macmillan's warning of a looming crisis is therefore a serious concern for us all."

The NCPC, Hospice UK and Marie Curie have joined Macmillan's call for the government to act, so that everyone – regardless of their diagnosis – can receive high quality palliative and end of life care.

Jonathan Ellis, director of policy and advocacy at Hospice UK, said: "These new estimates from Macmillan are worrying and highlight the immense pressures on end of life care.

"Everyone with a life-limiting condition must be able to receive high quality care, whatever their condition and wherever they are supported. Expanding care options is critical to meeting people’s needs and also reducing pressures on the NHS. Too many terminally ill people are cared for in hospital, with no clinical need to be there, who would be much better supported by a hospice or at home. 

"Things cannot continue as they are. The government must take action to improve end of life care for all, as recommended by the review of choice in end of life care. Without action, current pressures on end of life care will only worsen as people live and die with increasingly complex needs at the end of their lives."

Highlighting the potential risks of inaction, Scott Sinclair from Marie Curie adds: "Our concern is that without additional funding for community palliative care, the rising demand will lead to an increased number of people dying in hospitals, where resources are already stretched and people are less likely to experience dignity and respect at the end of life.

"We need to shift care for people with a terminal illness out of hospital and ease the pressure on NHS hospitals. It is possible for people to die at home in comfort and with dignity when the right support is in place."

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