Does the ageing population correctly predict the need for medical beds?: Part one: fundamental principles

Abstract

The World War II baby boom, coupled with increasing life expectancy, will lead to increasing numbers of deaths for the next 40 years. The last year of life represents a large proportion (55%) of lifetime hospital bed occupancy. This is called the nearness to death effect. However, the nearness to death effect has not been factored into NHS capacity planning, which largely relies on age-based forecasting, often called the ageing population. In certain locations, deaths are predicted to rise far more rapidly than the national average of 1% per annual growth. These locations are highly susceptible to capacity pressures emanating from the nearness to death effect, which is not compatible with recent policies that aim to build smaller hospitals. This article is the first of a two-part series discussing these trends in deaths and bed demand, as well as the likely impact on NHS capacity and the implications for the NHS funding formula.