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Pressure on palliative care to spiral over next 25 years

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Future predictions show 42% more people than at present will need palliative care in England and Wales by 2040, according to researchers.

The number of people requiring palliative care over the next 25 years is likely to “increase substantially”, requiring a “shift” in healthcare priorities, they warned.

“There is an urgent need to act now to transform health, social and palliative care services”

Irene Higginson

According to the researchers, the number of people in England and Wales who are likely to have palliative care needs will grow out of proportion to changes in population demographics.

As a result, palliative care services will require greatly increased resources over the next two decades to deal with this growing need.

They calculated that, by 2040, at least 160,000 more people each year are likely to have palliative care needs – including pain management of long-term conditions and end-of-life care at hospitals, hospices, and at home.

If all were to receive appropriate palliative care, the researchers said a significant increase in training and resources for both specialist and non-specialist care providers was needed immediately.

The projections also found that over half of all deaths will occur in people aged over 85 and that dementia deaths will almost quadruple by 2040, they noted in the journal BMC Medicine.

“An increase in palliative care training for care providers and more support for families is essential”

Ros Taylor

Dr Simon Noah Etkind, lead author from the Cicely Saunders Institute at King’s College London, said: “We estimate that at least 85% of deaths in 2040 will require some form of palliative care and we can predict a shift towards dementia as a greater contributor to palliative care need.”

Professor Irene Higginson, director of the institute and study co-author, said: “There is an urgent need to act now to transform health, social and palliative care services to meet the projected growth in palliative care need.

“More attention should be given to the needs of people and those close to them when facing progressive illness, particularly those dying from chronic and complex illnesses, and age related syndromes such as frailty and dementia,” she said.

“There is a need to support their families, who shoulder so much of the care,” she said. “The way in which we provide healthcare, and palliative care will need to change.”

Professor Higginson suggested more integrated approaches would be required, where patients could have “expert palliative care alongside their illnesses”.

“If we don’t act now, more people in future will go without the care they desperately need”

Simon Jones

The projections were based on data from the Office of National Statistics. The projections are based on current trends in disease prevalence and cause of death, which means the numbers presented are not a forecast of what will happen but of what may occur if recent trends continue.

Charities from the end of life care sector responded to the projections on future demand on services by agreeing that urgent action was needed now.

Dr Ros Taylor, clinical director at Hospice UK, said: “This projected massive increase in future demand for palliative care will have far-reaching implications for our healthcare system and society at large.

She described it as “something that all care providers, including families, need to prepare for now as a matter of urgency”.

“An increase in palliative care training for care providers and more support for families is essential to help meet these challenges,” she said, adding that the charity’s new five-year strategy involved more training partnerships between hospices and hospitals, care homes and other providers.

Simon Jones, director of policy and public affairs at Marie Curie, stated that the “scale of the problem is significant”.

Irene higginson

Irene Higginson

Irene Higginson

“It is clear that we need to radically rethink how we care for people at the end of their lives, to ensure everyone with a terminal illness gets the range of support they need, when they need it,” he said. “We need to start that process now, before we reach crisis point.”

He noted that the charity had launched the £3.5m five-year Design to Care Programme, working with University of Cambridge and Sheffield Hallam University, to “radically rethink” how palliative and end of life care could be delivered in future.

“If we don’t act now, more people in future will go without the care they desperately need, more will die where they don’t want to and more families and friends will have their lives devastated by the negative experiences of their dying loved ones,” he added.

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