Delays in fast-track care for dying patients

November 7, 2017

A report by Marie Curie has raised major concerns about a fast-track care system that is meant to allow seriously ill or dying patients in England to leave hospital quickly when they no longer need to be there.

The findings have revealed that a significant number of people around the country are being delayed in hospital, and potentially dying there, as they wait for urgently needed Continuing Healthcare (CHC) to be put in place.

While national guidance says that fast-track CHC should usually be delivered within 48 hours of being applied for, the report shows that in many cases this time-limit is being exceeded. Marie Curie estimates that in 2015/16, 57,000 people waited longer than two days for a package of care, of which just over 25,000 were waiting longer than a week.

Of the Clinical Commissioning Groups (CCGs) that provided the relevant data in response to Freedom of Information (FOI) requests by the charity (46% of all CCGs in England), less than a third (28%) were found to be meeting the 48-hour guideline, while for a further third (32%), the average waiting time exceeded a week. Some CCGs reported patients waiting more than two weeks to leave hospital.

Simon Jones, Director of Policy and Public Affairs for Marie Curie said, 'Fast-track CHC is crucial to seriously ill and dying people. It supports them with the care they need to get out of hospital and will often mean they are able to die where they want to.

'Delays which lead to people waiting beyond 48 hours to get the care package they need will inevitably lead to some people dying in hospital before arrangements can be put in place, causing significant distress to them and their loved ones. This is totally unacceptable.'

The report also raises concerns that the data represents the tip of the iceberg, given the number of CCGs that appear to not be collecting the information needed to assess how well their Fast Track CHC is being delivered.

Marie Curie is calling for NHS organisations to be held to the guidance laid out in the National Framework for CHC, both in terms of meeting the 48-hour timeframe and in conducting audits on their use of Fast-Track CHC.

Where CCGs did offer explanation for the waiting times people were experiencing, they identified a number of contributing factors, including: CHC being a Monday to Friday service, creating delays over weekends; delays in finding suitable care homes for patient discharge; and delays due to market capacity and local provider issues.

Marie Curie’s report follows a National Audit Office investigation into CHC funding earlier in the year. The full report can be found on the Marie Curie website.

 


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