Reviewing end of life care costing information to inform the QIPP End of Life Care Workstream

Document type
Corporate author(s)
NHS National End of Life Care Programme
NHS National End of Life Care Programme
Date of publication
27 September 2012
Health Services, Older Adults
Social welfare
Material type

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This report sets out to gather the current, available information on costing end of life care to inform a more robust steer for the potential costs and savings that the EoLC national programme can utilise as a framework for the Quality, Innovation, Productivity and Prevention (QIPP) activities for 2012/13 and beyond. It examines the available evidence to seek the answers to questions relating to end of life care costs in acute hospital settings and in community settings and to consider the potential cost savings of shifting the place of care. It concludes:

  • There are no robust, agreed costs of end of life care, but there is a range of costing information to draw on to inform the range of costs for end of life care in acute and community settings
  • There is no information if the cost of an admission ending in death or the cost of an inpatient day for the episode that ends in death is greater than, equal to or less than the current ‘price’; the complexities of ‘cost’, ‘price’ and tariff are explored further in the report
  • There are potential savings that could be released by shifting care from the acute to the community setting if such is the patient’s wish and if the commensurate disinvestment in acute care systems can be achieved
  • The document analysis shows that there is concern about the ability of current systems to realise the changes needed to release the funds for reinvestment and/or savings
  • There is much work still to do to develop robust cost information to support the continued development of high quality, cost effective end of life care
  • The work of the Palliative Care Funding Pilots (PCFPs) to develop the per-patient funding tariff through highlighting the actual costs of palliative and end of life care will greatly clarify the answers to some of the questions posed here