We have carried out future service capacity and demand modelling that will allow us to project the likely level of service provision that is needed over the next five years. We need an inpatient bed base that allows us to care and support patients with a range of needs. This includes
- Complex patients with a range needs who require intensive support
- Patients nearing the end of their lives who are not able or do not wish to stay in their own home
As palliative need and deaths are directly correlated, we know that palliative need across NW London is projected to grow by 12.7% over the next 5 years. Approximately 3% of those with palliative needs may end up using an inpatient bed.
This leads to a projected increase in the number of admissions to inpatient units (IPU) where people have to stay in a bed for at least one night from 962 per year to approximately 1,084 admissions by the year 2027. Similarly, it is predicted that the number of days in which NW London patients occupy beds will grow from 15,775 to 17,781 by the year 2027.
It is, however, important to relate this to the number of bed days contracted by NW London across the seven hospice providers with inpatient units.
Presently, NW London contracts 20,719 bed days (inclusive of Pembridge Palliative Care Service commissioned beds). Taking into account that many, if not all patients who would have used Pembridge used alternative hospice beds average occupancy of hospice beds across NW London in 2021 was 76%.
Based on future demand projections, with current hospice inpatient unit’s arrangements remaining in place (consultant-led hospice inpatient unit commissioned bed days), the average occupancy of contracted beds would increase to 86%.
Although ‘unused’ capacity must remain in place to account for fluctuations in demand and operational constraints, it is projected that there is both sufficient and unutilised capacity in the inpatient unit bed-stock to address the predicted increase in demand for hospice beds.
Projecting our future inpatient bed (IPU) requirements over the next five years
We have calculated a 12.7% increase in the number of unique patients accessing all service lines by the year 2027 against current usage. We are able to do this as palliative care need is directly linked to the number of deaths.
We have used NW London and ONS death data and projections for future rates of death and this shows there is a predicted year on year increase of deaths and thus palliative need of 1.99% across NW London, translating to a 12.7% increase by 2027. See figure below.
NW London is projected to experience a 12.7% increase in CSPC demand by 2027
Variation in service access, demand and provision may be hidden by looking at service lines in totality and using averages, which unless effectively addressed, may widen over time.
There is fragmentation of services and variation in across boroughs, resulting in differential access to varied service types for populations across NW London.