Abstract

A dramatic increase in deaths in the UK since 2011 has defied actuarial forecasts. This has led some to propose a direct link between the rise in deaths and government social care austerity. However, several facts argue against this link. Firstly, age standardised mortality in the second quarter of 2019 was statistically lower than the second quarter in all years since 2001, clearly austerity is still present, but age standardised mortality has recovered. Also, deaths have increased equally across the whole of the UK, whereas social care austerity has largely been restricted to England. English citizens who are residents outside of the UK also show the same trend. These effects are highly reminiscent of a recurring series of disease outbreaks of an unidentified pathogen. In addition, increases in deaths are always linked to increases in hospital admissions. This link arises since around half of a person's lifetime use of acute services is compressed into the last 6 months of life, irrespective of the age at death. This is called the nearness-to-death effect. International research is needed to understand exactly why deaths are behaving in this unique way. While austerity has created a significant problem relating to delayed discharges in hospitals and has highlighted serious problems with how end-of-life care is to be funded, it seemingly cannot be blamed for the increased mortality rate.

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