27 April 2016
New estimates from Macmillan Cancer Support show growing demand for end of life care will put an ‘intolerable’ strain on the NHS and social services.
Nearly 144,000 people a year in England are expected to die of cancer by 2020[i], according to an alarming new estimate from Macmillan Cancer Support – which equates to one person dying of the disease every four minutes. This means an extra 15,000 people could be dying of cancer in 2020 in England, compared to in 2010[ii].
Macmillan Cancer Support says the estimate, based on recent Office for National Statistics (ONS) population projections and past trends in cancer deaths from Public Health England, highlights the urgent need to tackle the country’s ‘deeply imperfect’ approach to end of life care. Many dying patients currently lack adequate pain relief, are not being involved in vital decisions about their care and are unable to die at home if they want to because they lack support.
Previous Macmillan research shows that most people with cancer (73%)[iii] would prefer to die in the familiarity of their own home, and yet ONS data shows only a minority (30%) are able to do so[iv].
The charity says that if people dying of cancer are to be spared further distress and pain, the Government must invest in much-needed services such as out of hours community services for people at the end of their life, as recommended in an independent landmark review of choice at the end of life published last year.
The government has yet to respond to the recommendations of the review, which Macmillan Cancer Support says should be fully funded.
As more people are diagnosed with cancer and the country’s population grows and ages, the situation is likely to worsen if immediate action is not taken. Macmillan Cancer Support predicts that if government does not act to improve the situation, then nearly 65,000 people dying of cancer will have experienced poor overall care in their last three months of life over the next five years[v].
Ian Nutley, 60, from Bedfordshire lost his mother Jessie to cancer in 2012.
Ian says: ‘My mother was clear about her end of life wishes, she wanted to die at home but much to our sadness, that did not happen. She’d been in a care home after my father died and had developed Alzheimer’s, but after unexplained weight loss she was admitted to hospital for emergency tests.
“The X-rays showed she had terminal lung cancer but we were shocked when both the hospital and care home refused to take any further part in mum’s care. The hospital told us she had to return to the care home but the care home wouldn't take her.
“After hitting that brick wall, we managed to get her into another care home but when we told them about her wishes to die at home, they said it would not be possible. She died that July and never did return home.”
Lynda Thomas, Chief Executive of Macmillan Cancer Support, says:
“It is shocking to think that one person will die of cancer every four minutes, but worse still that many people dying of cancer may not get the care they need, and that their final wishes will remain unfulfilled.
"It is unacceptable for a person dying of cancer to have to go to hospital when they don’t want to be there, because care and support wasn’t available at home. If the government really wants to improve end of life care for everybody, then investment is vital. If nothing is done and the country’s deeply imperfect arrangements continue, then end of life care is heading for a meltdown.
“That is why the government must fully fund the recommendations put forward in last year’s independent review of choice at the end of life such as a shared record of people’s preferences at the end of life. Without action now, thousands of people with cancer will not have the high quality, compassionate end of life care that everybody should experience.”
To find out more about Macmillan’s campaign on end of life care, please visit: www.macmillan.org.uk/endoflife
For further information, please contact:
Patrick Pringle, Media & PR Officer, Macmillan Cancer Support
0207 840 4891 (out of hours 07801 307068)
Notes to Editors:
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.
That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.
To get involved, call 0300 1000 200 today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit macmillan.org.uk
[i] Macmillan Cancer Support forecast based on a 10 year linear trend in crude cancer mortality rates between 2004 and 2013. The rates include all deaths due to malignant neoplasms (excluding non-melanoma skin cancer) in England and are sex and age specific (6 age bands). The information on deaths is taken from National Cancer Registration and Analysis Service, Public Health England. CancerData. https://www.cancerdata.nhs.uk/ extracted April 2016. The predicted mortality rate is then multiplied by the expected population according to the Office for National Statistics 2014-based projection (ONS. 2015. Table A1-4, Principal Projection - England Summary. http://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/datasets/tablea14principalprojectionenglandsummary accessed April 2016). These forecasts assume that current long term trends continue so does not take account of unexpected shifts in cancer mortality.
[iii] Statistic taken from Macmillan February 2010 online survey of 1,019 UK adults living with cancer. Seventy-three percent of people with cancer said they would prefer to die at home if all their concerns about dying at home (such as access to pain relief, round the clock care, and support for their family and carers) were addressed.
[iv] Office for National Statistics. Mortality statistics: Deaths registered in England and Wales in 2014.
[v] Macmillan Cancer Support analysis based on the sum of expected cancer deaths in 2016 to 2020 (i) and the proportion of cancer deaths where the bereaved believed that overall, and taking all services into account, care of the deceased in the last three months of life was rated 'poor'. This proportion was taken from the National Survey of Bereaved People 2014 and assumed to be constant till 2020 if there is no government action. (Office of National Statistics. 2015. National Survey of Bereaved People (VOICES), 2014. http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=tcm%3A77-407293)