SAIL Databank enables landmark study on end-of-life care in Wales, published in The Lancet

A major new study, funded by Health and Care Research Wales and commissioned through the Health and Care Research Wales Evidence Centre, has been published in The Lancet Regional Health – Europe, offering vital insights into how people in Wales access health and care services in the final year of life.

The research, led by a multidisciplinary team from Population Data Science at Swansea University, in collaboration with Cardiff University, Bristol University, and the Welsh National Clinical Programme for Palliative and End of Life Care, harnessed the power of anonymised, linked data from the SAIL Databank, which is also funded by Health and Care Research Wales.

Drawing on data from over 267,000 individuals in Wales who died of non-sudden causes between 2014 and 2023, the study modelled more than 1.8 million transitions between health and care settings. The analysis explored hospital admissions, care home stays (with and without nursing) and community-based care, with a particular focus on individuals registered for palliative care.

Key Findings:

• Demand for urgent care increased rapidly towards the end-of-life.
• The majority of time in the last year of life was spent at home.
• 90% of emergency hospital admissions came from people’s own homes.
• Individuals on the palliative care register had an increased rate of urgent hospital admissions but decreased expected length of stay.

The study concludes that more targeted approaches are needed to identify individuals who would benefit from palliative care earlier, enabling timely and appropriate support at home. Strengthening home-based care and improving early identification can help meet people’s preferences for end-of-life care while ensuring more effective use of health and care resources.

Professor Rhiannon Owen, Senior Research Leader at Health and Care Research Wales, said: “This work enabling a system-wide evaluation for the population of Wales was only made possible by linkage of anonymous health and administrative data facilitated by the SAIL Databank. Our findings provide a vital evidence-base to support ministerial policy and decision-making to design a more efficient, compassionate and equitable end-of-life care in Wales.”

The research was carried out in response to the Welsh Government’s National Programme for Palliative and End of Life Care to provide a vital evidence base to guide future planning and policy, helping Wales deliver more equitable and person-centred end-of-life care.

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