King's College London

Academic Institute

CCU110

The Covid-19 pandemic changed the way that people accessed healthcare, including care towards the end of life, where we saw a sustained shift towards more care in the community. Many people want to avoid hospital towards the end of life, but we know that in 2020, 63% of people still had one or more visits to an emergency department in their last 3 months of life. What is less well understood is how much hospital activity (i.e. unplanned hospital visits and bed days) there is for people in the last year of life, and how this may have changed before, during, and after the Covid-19 pandemic. The aim of this work is to understand the impact of the Covid-19 pandemic on how much unplanned hospital activity there is for people in the last year of life. This study will provide vital evidence needed to understand pressure on the NHS and to plan more effective and equitable care in the future. Equitable care means providing health and social care that meets the needs of all people, regardless of their age, gender, ethnicity, socioeconomic status, location or other background characteristics.

The new 10-year plan for the NHS has a strong focus on shifting care from hospital to community services. We have some evidence that the Covid-19 pandemic prompted a shift in palliative and end of life care to the community, for example our earlier research showed an increase in deaths from chronic illness at home and a corresponding decrease in deaths in hospital. But we do not understand how the Covid-19 pandemic changed patterns of unplanned hospital use. This research is being funded by Marie Curie who have commissioned this work to support their efforts to generate evidence on the most effective and equitable resourcing of health and social care for dying people, and on ways to reduce pressures on hospital services. Learning about the impact of the Covid-19 pandemic and whether these changes have been sustained is key to future planning. This work has a high potential for real world impact through informing policy. The research team will work with the British Heart Foundation Data Science Centre and the funder of this work – Marie Curie (grant code: MCCRP-24-06) - to disseminate the findings through engagement with policy makers, the public, the mainstream media, and through presentations of the work at academic conferences.

This project accessed the following datasets within the Trusted Research Environment(s) for CVD-COVID-UK / COVID-IMPACT: - ENGLAND: - GPES Data for Pandemic Planning and Research (COVID-19) - Hospital Episode Statistics Admitted Patient Care - Hospital Episode Statistics Accident and Emergency - Emergency Care Data Set (ECDS) - Civil Registration - Deaths

01/11/2025

30/04/2026

18/12/2025

De-Personalised

18/12/2025

TRE