75% of terminally ill cancer patients attended A&E during final year
Almost three in four of terminally ill cancer patients in Northern Ireland in 2015 had at least one emergency admission in the last year of their life.
Outcomes for more than 4,300 patients were examined in their last year of life by Macmillan Cancer Support and the NI Cancer Registry at Queen’s University Belfast in a new report on emergency admissions in 2015.
It found that one in six patients died within seven days of their last admission, almost all in hospital despite research showing that most people would prefer to die at home.
More than half of the cases examined in the report found that these admissions took place when care from services including the Acute Oncology Service were unavailable outside working hours.
The report demonstrates the significant pressures on emergency departments within the health and social care system, in supporting the 1 in 4 who currently die of cancer in Northern Ireland.
It was also discovered that late diagnosis is an issue, with one in nine people admitted in an emergency receiving a cancer diagnosis the same day.
Another quarter were admitted one to three months before their cancer diagnosis.
Those with at least one emergency admission were twice as likely to die while in hospital.
The report contains recommendations to focus on more 'person-centred care' - which includes the early identification of patients who are in their last year of life and continuing to promote early detection of cancer.
It also recommended additional training for healthcare professionals to improve advance care planning and establishing a direct point of contact for patients and their carers.
The extension of opening hours for the NI Acute Oncology Service and further development of community-based services is also recommended.
Dr Anna Gavin, who is the director of the NI Cancer Registry at Queen’s University Belfast hopes the report will inform decision-making, increase collaboration and ultimately improve cancer services across the north.
"Our findings show that the burden of emergency admissions for cancer patients in the last year of life is high. This has huge implications for the patient, their family and carers and the wider health and social care system.
"The six recommendations we have made could reduce the number of emergency admissions for cancer patients in the last year of life," she said.
Heather Monteverde, head of services at Macmillan, said that improved "quality" end-of-life care was required.
"This report finds that in far too many cases, people's individual needs are not being met. The fact that so many people are receiving a devastating cancer diagnosis after an emergency admission demonstrates that much more needs to be done to ensure a whole system approach to enabling person-centred care which integrates primary, secondary and community care resources," she said.
"It’s also important that health care services are universally strong at identifying people who are approaching the last year of their life. Better communication between patients and professionals about end-of-life choices is essential.
"All health care professionals should be supported so they can confidently have conversations with people about death and enable shared decision-making and advance care planning."
Belfast Telegraph Digital