The growing number of end-of-life patients in hospital could impact the level of treatment provided this winter, a group of regional NHS bosses have been told.
A palliative care consultant highlighted a looming “crisis” during an internal online meeting of health leaders in Sussex, a recording of which was heard by the BBC.
A consultant at Sussex University Hospitals NHS Trust has described the dilemmas facing hospital bosses when some patients have to receive end-of-life care in emergency corridors.
The gloomy assessment is likely to be repeated in other NHS regions as increasing winter pressure makes it harder to find hospital beds for sick patients needing care.
University hospitals in Sussex include Worthing Hospital, Royal Sussex County Hospital, St Richard's Hospital Chichester and the Princess Royal Hospital Haywards Heath.
Doctors and officials from East Sussex Healthcare NHS Trust, which includes Conquest Hospital in Hastings and Eastbourne District General Hospital, also attended the meeting along with public health officials.
At the meeting on 4 November, the consultant presented a slide presentation on the topic 'Palliative and end of life care in Sussex'.
She told the audience that local hospices are struggling and it is difficult to find places for patients needing end-of-life care, although it is sometimes unclear what support there may be in the local community when people are sent home.
She said: “I am very concerned that patients who have treatable conditions will not be able to get to hospital and receive treatment because there are so many patients in hospital beds at the end of life.”
She went on to say, “We are no longer putting patients on the transfer queue who are simply dying,” focusing only on those with complex needs.
Regarding the provision of advanced palliative care in the emergency department, the consultant said it was a “really difficult choice: whether to admit them to corridor care or turn them around, put them in the back of an ambulance where they could die on the way home.”
She argued that the hospital has “a lot of patients who don't need to be there, a lot of patients with complex needs whose needs are not being met.”
She concluded: “We all knew this crisis was coming – it's getting worse and worse.”
A Sussex NHS spokesman said it was committed to ensuring patients have access to the “best, highest quality palliative and end-of-life care”.
They said: “This includes providing a range of places for compassionate, person-centred care – and, importantly, where possible, in non-hospital settings, such as in community settings and our hospices.
“Accident services in Sussex remain under significant pressure, but staff continue to work incredibly hard to ensure patients can get the care they need in our hospitals and across our health and care services.
“There is a lot of partnership work going on over the winter period to support individual care plans and ensure people receive the NHS services that suit their needs.”
But the Royal College of Emergency Medicine said delayed discharge is a huge problem for the NHS, and a lack of social or community care could mean some patients requiring end-of-life care and support are unable to leave hospitals.
Its president, Dr Ian Higginson, said the college was “concerned about the number of patients requiring end-of-life care who end up in emergency departments and then hospitals because the specialist services they need are not available”.
He said: “Patients who would rather be at home may find themselves in our corridors, which are not a suitable place for anyone, let alone those at the end of their lives.”
Meanwhile, public services are also being stretched, with hospices warning of a funding crisis.
Toby Porter, chief executive of Hospice UK, said: “We know how hard NHS and care staff work to give people the end-of-life care they deserve.
“But while a hospital may be the right place for some, a busy ward is not the right place for most people who die.
“Hospices across the country want to provide more care to the population, but this year we have seen it cut back due to a lack of funding. And that has a knock-on effect on hospitals.”
