A growing number of end-of-life patients occupying hospital beds could limit access to treatment for other patients this winter, NHS leaders in Sussex have been warned, amid mounting pressure on emergency departments and community care services.
Concerns were raised during an internal online meeting of regional health leaders in Sussex, where a consultant in palliative care warned of an approaching “crisis” in how hospitals manage patients nearing the end of their lives. A recording of the meeting, held on 4 November, was heard by the BBC.
The consultant, from University Hospitals Sussex NHS Trust, told colleagues that rising numbers of patients needing end-of-life care were occupying acute hospital beds, creating difficult choices for managers and clinicians as winter pressures intensify.
Hospitals involved in the discussions included Worthing Hospital, Royal Sussex County Hospital in Brighton, St Richard’s Hospital in Chichester and Princess Royal Hospital in Haywards Heath, as well as clinicians from East Sussex Healthcare NHS Trust and community health services.
End-of-life care in A&E corridors
In a presentation titled “Palliative and End of Life Care in Sussex”, the consultant described situations in which patients at the end of their lives were receiving care in A&E corridors due to a lack of suitable alternatives.
She told the meeting that local hospices were struggling to accommodate patients and that support in the community was often unclear when patients were discharged home. As a result, hospitals were sometimes forced to keep dying patients in acute settings that were not designed for compassionate end-of-life care.
She warned that the pressure could prevent patients with treatable conditions from being admitted. “I am really worried that patients who have treatable conditions are not going to be able to get into hospital and be treated because there are so many end-of-life patients in hospital beds,” she said.
Hospitals prioritising complex cases
The consultant said hospitals had stopped placing patients who were “straightforward dying” on transfer waiting lists, focusing limited resources instead on patients with more complex palliative needs.
She described the ethical dilemmas facing clinicians in emergency departments, asking whether it was better to admit patients for corridor care or send them home in ambulances where they might die en route.
She also argued that many patients remained in hospital because their complex needs could not be met elsewhere, adding that the situation had been building for years and was continuing to deteriorate.
NHS response in Sussex
A spokesperson for the NHS in Sussex said services were committed to providing high-quality palliative and end-of-life care and emphasised the importance of supporting people outside hospital settings wherever possible.
They said emergency care services across Sussex were under significant pressure but that staff were working hard to ensure patients received appropriate care, supported by winter partnership arrangements designed to place people in the right NHS service for their needs.
National concern over delayed discharges
The Royal College of Emergency Medicine said delayed discharges remained a major challenge across the NHS, with shortages in social care and community services preventing some patients from leaving hospital.
Its president, Dr Ian Higginson, said the organisation was concerned about the number of patients requiring end-of-life care who end up in emergency departments because specialist services are unavailable.
He warned that patients who would prefer to die at home were instead spending their final days in hospital corridors, which he said were wholly inappropriate environments for end-of-life care.
Hospices warn of funding crisis
The pressure on hospitals is being compounded by a funding crisis in the hospice sector. Hospice UK said many hospices want to expand community-based care but have been forced to scale back services this year.
Chief executive Toby Porter said while hospital care is appropriate for some patients, most people do not want to die on busy wards. He warned that cuts to hospice and community care were having a direct knock-on effect on hospitals already struggling with winter demand.
Winter pressures across the NHS have been exacerbated by high bed occupancy, delayed discharges, staff shortages and rising demand from an ageing population, making end-of-life care a growing challenge nationwide.
