Prescribing for patients at the end of life

Abstract

Approximately 550 000 people in the UK die each year, and mortality rates are set to rise. It is anticipated that the annual number of deaths per year in the UK will have increased by 17% by the year 2030. This rise is attributed largely to an aging population. The three main causes of death within the UK are circulatory disease, respiratory disease, and cancer (Office for National Statistics, 2017). The NHS plays a large part in the care of people who are dying; this care includes enabling people to choose where they would like to be in their last days of life. Place of death is particularly important to many people who receive a diagnosis of a terminal condition and research suggests that most people want to die at home—around 63%. Just 28% of people wish to die in a hospice, 8% in hospitals and 1% in nursing or residential care (Help the Hospices et al, 2013). The cost of caring for people at the end of life is financially expensive to the NHS but is indisputably a vital part of the patient and family's journey and the human cost when this is not achieved may be immeasurable. The financial cost to the NHS in the last 90 days of life can vary dependant on the care setting; however, on average, £4500 is spent on hospital stays per person, hospice care is estimated at around £550 per day and the average cost of community nurse visits is estimated at £278 per day (NHS Confederation, 2017).