Specialist palliative care saves the NHS up to 7,908 pounds per patient and improves quality of life

Published in Palliative Medicine, 2026. King's College London.

About 1% of people in high-income countries die each year. That small fraction accounts for 8 to 10% of all healthcare spending, driven largely by unplanned hospital admissions in the final months of life. Most people with serious illness say they would prefer to receive care at home. Many die in hospital instead.

A new economic modelling study now puts a price on what specialist palliative care can change. Published in Palliative Medicine, the research estimates that home-based specialist palliative care reduces costs by 7,908 pounds per person who dies, while hospital-based specialist palliative care reduces costs by 6,480 pounds. Both modes of care were associated with improved quality of life in patients' final months.

The scale in England

The researchers, from King's College London, Hull York Medical School, and the Universities of Hull and Leeds, applied their model to England's 2022 data. They estimated that specialist palliative care supported more than 20,000 people to die outside of hospital that year, saving approximately 1.5 million hospital bed days and reducing healthcare expenditures by roughly 817 million pounds.

Those are not abstract savings. Each avoided hospital bed day represents a patient who received care in a setting they preferred, and a bed freed for someone else in a health system under persistent capacity pressure.

How the savings work

The cost reductions come primarily from avoiding unplanned hospital admissions. When patients with serious illness lack specialist palliative support, crises often lead to emergency department visits and hospital stays that are expensive, fragmenting, and frequently unwanted by the patient. Specialist palliative care teams, whether visiting patients at home or embedded in hospital wards, manage symptoms proactively, coordinate care plans, and help patients and families navigate decisions about treatment intensity.

Quality of life was measured across five dimensions: mobility, self-care, usual activities, pain, and anxiety or depression. Both home and hospital palliative care were associated with improvements on these measures compared with standard care alone.

Half of eligible patients do not receive it

The study carries an implicit challenge. The researchers estimate that only about half of people who might benefit from specialist palliative care actually receive it. The gap is not primarily one of evidence, the data supporting palliative care's effectiveness are substantial, but of access, awareness, and sometimes reluctance.

"Many people may be reluctant to ask for palliative care, believing that it might accelerate their decline and impose additional pressure on the health service," said Professor Fliss Murtagh at Hull York Medical School. "The reverse is true."

Peter May, Senior Lecturer in Health Economics at King's College London and lead author, noted that the study raises a follow-up question that matters more than the economics. "We must now turn our attention to understanding how and why people who might benefit do not yet receive palliative care."

What the model does not capture

Economic modelling combines the best available evidence from existing research and government statistics, but it is not the same as directly measuring outcomes in a trial. The cost estimates depend on assumptions about hospital admission rates, length of stay, and the counterfactual of what would have happened without palliative care. These assumptions are informed by evidence but carry uncertainty.

The study also does not address the cost of providing specialist palliative care itself, including hospice funding, community team staffing, and training. The net savings after accounting for the full cost of delivering the service would be lower than the gross figures reported, though previous research suggests the economics remain favorable.

Specialist palliative care requires a workforce with specific skills and experience. Expanding access to the other half of eligible patients who currently miss out would require significant investment in training and recruitment at a time when the healthcare workforce is already stretched thin across multiple specialties.

The core finding, though, is difficult to argue against on any dimension. Specialist palliative care appears to cost less than the alternative, produce better outcomes for patients, and align with what most people say they want at the end of life. The challenge is not making the case. It is closing the gap between what the evidence supports and what the system delivers.