Refreshed ten-year demand projections for hospice in-patient care

In 2023 we created a data pack showing demand and capacity data modelling to inform our thinking on the number of hospice beds required to support the needs of NHS NW London for the next five years.

The data was released alongside the model of care and we subsequently engaged with local residents and stakeholders on the proposals in September and October 2023.

As part of this engagement, there were three specific points raised in relation to the data:

  • Are beds evenly distributed to serve our borough populations?
  • Have we used a consistent approach to measuring bed capacity?
  • How does use of 2023/24 data affecting our modelling?

What has changed (and is reflected in this new updated paper) since the original data publication:

  • We know at a borough level that the majority of residents are evenly served by the current 57 operational beds. The south of Hillingdon being the exception to this.
  • We have 57 hospice in-patient beds instead of 56. The difference is the result of measuring capacity consistently across all beds, including spot purchasing arrangements.
  • Greater variation in use of hospice in-patient beds in 2023/24 means we have considered a range within which we expect demand to present. At the upper end of our modelling, we would expect to have sufficient hospice bed capacity to meet our needs until 2027/28.  

The new updated data paper can be viewed here on our website. 

Ten-year demand projections for in-patient hospice care

To understand whether we have the hospice inpatient beds needed to serve the inpatient needs of our population, we have undertaken an analysis of future demand and compared this with the capacity we currently have 

Click here to view the full analysis.

The methods used for projecting future need

  1. Understand how mortality in NWL changes over the next 10 years based on national statistical studies and applying local data.
  2. Apply the annual rate of mortality growth to number of people who may require palliative care.
  3. Include additional allowance for needing to address unmet need i.e. people who are not currently accessing care but need it.
  4. Apply the rate of growth to bed use over 10 year period.
  5. Compare future bed use with available capacity to determine when and if the demand for beds exceeds available capacity.

Mortality in our popultation

  • We anticipate increasing number of deaths each year, climbing from 12,300 in 2023 to 14,500 in 2033. 
  • This is driven largely by an ageing population. This is expected to result in a corresponding increase in number of people needing palliative care. In addition, there are likely to be people who are not receiving palliative care when they should be we refer to this as ‘unmet need’.
  • If we assume we steadily work to improve public awareness and meet the palliative care needs of our whole population, we expect the number of people with a palliative care need to grow from 31,000 in 2023 to 37,000 in 2033.

Hospice inpatient demand

  • If we assume the demand for inpatient care grows proportionally to overall palliative care need and there are no changes to the length of time each bed is used each time it is used, we can expect the number of bed days needed to grow from approximately 15,000 bed days per year in 2023 to 18,000 in 2033.

Conclusions arising out of analysis

  • If the number of beds we use does not change over time, we can expect to have space (capacity) for approximately 20,400 bed days each year.
  • Comparing expected increase in demand with available capacity, we will have enough beds to meet our needs until 2031.
  • Beyond this time, we would need to make adjustments to either demand or capacity.
  • According to our data analysis and based on an assessment of unmet need and demographic growth, we do not require more specialist hospice in-patient beds than those currently being commissioned and used.  

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