• Run by Imperial College London, in collaboration with the University of Edinburgh and the Institute for Public Policy Research (IPPR).
  • Research project that is aiming to inform a more efficient allocation of health and social care resources in the provision of end-of-life care.
  • Will analyse linked datasets from England and Scotland and develop an end-of-life care micro-simulation model.
  • Will explore patient views and discuss potential barriers with health care commissioners.

The number of deaths each year in the UK is expected to increase by 17% by 2030. The cost of caring for patients who are at the end of their life is therefore set to increase, and there are also significant inequalities in access to appropriate end-of-life services.

While patients express a strong preference to die in their usual place of residence, the majority of deaths occur in hospital, where patients often undergo intensive treatments without any apparent tangible benefits in terms of survival or quality of life.

This round two Efficiency Research project will look at whether improvements in the efficiency of health and social care delivery at the end of life could enable access to higher-quality and more personalised care for patients.

A research team at Imperial College London will first review the literature on the cost and cost effectiveness of end-of-life care, focusing on advanced care planning and palliative care. They will then use linked patient-level datasets from England and Scotland to model health and social care pathways, and associated costs, in the last year of life.

The evidence this research produces will inform the development of a micro-simulation model. The model will be used to assess the potential impact of evidence-based end-of-life care delivery models in England and Scotland, with a focus on costs, transitions between care settings and place of death.

The team will also analyse potential barriers to the more efficient use of resources in end-of-life care, both from the perspective of the patient and the health system.


Dr Joachim Marti, Lecturer in Health Economics, Imperial College London, j.marti@imperial.ac.uk

Darshan Patel, Senior Research Manager, the Health Foundation, darshan.patel@health.org.uk​