Heavy workload during the 2016/17 winter was entirely predictable

In two previous articles, I explored the issues around rising unscheduled demand for healthcare services, and whether outbreaks of a new type of infectious disease may be, in some way, implicated (Jones 2014a, 2015a). In this respect, a further outbreak of this agent occurred during 2016, and unusually high workload during the winter of 2016/17 had already been predicted (Jones 2016e).

This update will focus on the trends in deaths as a proxy for the rising health service demand over the last weeks of life. It has been known for many years that the majority of a person's lifetime acute utilisation (up to 55%) occurs in the last year of life, and more specifically in the last 22 weeks of life (Beeknoo and Jones, 2016). Hospital admissions (and ambulance journeys) reach a crescendo in the last month of life. However, this occurs irrespective of the age at death, i.e. it is a fundamental biological process of deterioration resulting in functional, cognitive and biochemical decline (Beeknoo and Jones, 2016; Jones et al, 2016); hence, the trend in deaths will be highly indicative of the pressure on ambulance services.