An internal Sussex NHS briefing has warned that rising numbers of patients requiring end-of-life care are occupying acute beds and could constrain the level of treatment delivered this winter. In a recording heard by the BBC, a University Hospitals Sussex consultant described how some patients are receiving palliative care in accident and emergency corridors amid severe bed pressures.
The remarks were made on 4 November during an online meeting of regional leaders from University Hospitals Sussex NHS Trust and East Sussex Healthcare NHS Trust, joined by community health representatives. Presenting ‘Palliative and End of Life Care in Sussex’, the consultant outlined dilemmas facing managers when hospice places are unavailable and community support is uncertain.
The consultant said teams were ‘no longer putting patients on the waiting list for transfer who are just straightforward dying’, prioritising those with complex needs. On enhanced palliative care in A&E, she described the choice facing clinicians: admit for corridor care or turn the patient around to an ambulance knowing they could die on the way home. She added that many patients in hospital did not need to be there, while others with complex needs had gaps in provision.
She cautioned that patients with treatable conditions might struggle to access timely admission because so many end-of-life patients are in hospital beds, concluding that ‘we’ve all known this crisis is coming’. University Hospitals Sussex covers sites including Worthing, the Royal Sussex County Hospital in Brighton, St Richard’s in Chichester and the Princess Royal in Haywards Heath.
A spokesperson for the NHS in Sussex said the system is committed to providing high-quality, person-centred palliative and end-of-life care across a range of settings, with an emphasis on out-of-hospital options such as community services and hospices. They acknowledged that emergency care services remain under significant pressure but said staff are working to ensure patients receive the care they need and that ‘robust partnership work’ is in place over the winter to support individual care plans and direct people to the right service.
The Royal College of Emergency Medicine said delayed discharges remain a major challenge and that limited social or community care means some patients needing end-of-life support cannot leave hospital. Its president, Dr Ian Higginson, said the college is worried about the number of people who end up in emergency departments and then wards because dedicated services are not available, noting that some who would prefer to be at home find themselves in corridors.
An NHS clinician who contacted the BBC said end-of-life care delivered in emergency departments, corridors and ambulances, or via unsupported discharges home, has become increasingly routine across multiple regions. They highlighted a recurring pattern of hospital beds occupied by dying patients who should be cared for elsewhere and limited or delayed access to hospice or community services.
The NHS Confederation, which represents health service leaders, said hospitals often become the default when community and social care are under pressure or unavailable. Rory Deighton, director of the Confederation’s acute network, said the solution requires investment across the whole system rather than asking hospitals alone to absorb further strain.
Hospice UK warned of a funding crisis in the sector. Chief executive Toby Porter said that while hospitals are appropriate for some people, most would not choose to die on a busy ward, and that hospices want to expand community provision but have had to cut back this year because of funding pressures, increasing knock-on effects for hospitals.
Policy Wire analysis: The testimony and official responses indicate a system-wide bottleneck around discharge and community capacity. Without reliable hospice places and funded community packages, acute teams face difficult choices in emergency departments and higher ward occupancy, with likely consequences for elective recovery and urgent care flow through the peak winter period.