Hospitals Alerted to Impending Crisis in End-of-Life Care

Healthcare leaders have been cautioned about the growing number of patients requiring end-of-life care in hospitals, potentially compromising treatment quality this winter.

During a virtual meeting among Sussex health executives, a palliative care consultant raised alarms regarding this escalating “crisis,” as revealed by an audio recording.

This consultant, affiliated with University Hospitals Sussex NHS Trust, discussed the tough choices facing hospital administrators as some patients are being accommodated for end-of-life care in the corridors of emergency departments.

Challenges Amplified by Winter Pressures

This grim outlook is likely to resonate in various NHS areas, especially as the added pressures of winter intensify the struggle to secure hospital beds for patients in need of urgent care.

The University Hospitals Sussex Trust encompasses Worthing Hospital, Royal Sussex County Hospital, St Richard’s Hospital in Chichester, and Princess Royal Hospital in Haywards Heath.

Officials and medical professionals from East Sussex Healthcare NHS Trust, which includes Conquest Hospital in Hastings and Eastbourne District General Hospital, also participated in the meeting alongside community health representatives.

The Presentation and Its Implications

The consultant presented a slide deck titled “Palliative and End of Life Care in Sussex” during the session held on November 4.

She expressed concerns about local hospices facing challenges, indicating that it has become increasingly difficult to secure accommodations for patients requiring end-of-life care.

Additionally, she noted a lack of clarity regarding the level of support available within the community for patients discharged home.

“I am genuinely concerned that patients with treatable conditions might not be able to access hospital care due to the overwhelming number of end-of-life patients occupying beds,” she stated.

The consultant elaborated that the hospital is no longer placing patients on transfer waiting lists unless they present with complex needs, indicating a shift in priorities.

Ethical Dilemmas in Emergency Care

Regarding enhanced palliative care in emergency departments, she remarked on the ethical dilemma: whether to admit patients for corridor care or to send them home in an ambulance, risking their lives during transit.

She emphasized that many patients currently in hospitals do not require hospitalization, while numerous others with complex needs are not receiving adequate care.

“This crisis has been anticipated, and its severity is escalating,” she concluded.

A spokesperson for the NHS in Sussex reaffirmed their commitment to providing high-quality palliative and end-of-life care, stating, “This includes offering a variety of compassionate, person-centered care options, particularly in community settings and hospices whenever feasible.”

Despite ongoing pressures on emergency services across Sussex, the spokesperson highlighted the dedication of staff to ensure patients receive necessary care in hospitals and other healthcare facilities.

Concerns from the Royal College of Emergency Medicine

However, the Royal College of Emergency Medicine pointed out that delayed patient discharges present a significant challenge within the NHS system.

The absence of social or community care resources may prevent some patients requiring end-of-life care from leaving hospitals.

Dr. Ian Higginson, the college’s president, expressed concern about the increasing number of patients needing end-of-life care who find themselves in emergency departments and hospitals due to unavailable essential services.

He added, “Patients who wish to be at home often end up in our corridors, which are unsuitable for anyone, especially those nearing the end of life.”

Community Services Under Strain

Simultaneously, community health services are also experiencing strain, with hospices warning of a looming funding crisis.

Toby Porter, CEO of Hospice UK, noted, “We recognize the tremendous efforts of NHS and care staff in providing the care that individuals at the end of life deserve.”

He further remarked, “While hospitals may serve as appropriate environments for some patients, a crowded ward is hardly the right setting for most individuals approaching death.”

Porter concluded by stating that hospices across the nation aspire to enhance community care, but funding constraints have led to reductions in services, which in turn negatively impacts hospitals.