How does palliative care fit into national health spending? Long-term healthcare expenditure trends in the UK—secondary analysis

Objectives Current methods of health expenditure reporting make spending on palliative care services difficult to quantify. This paper (1) examines trends in the components of government (public) spending on health-related long-term care reported in the UK Health Accounts for the period of 2013–2022 to establish the wider context of palliative care expenditure, and (2) relates these trends to existing knowledge of expenditure on specialist palliative care services in the UK. Methods We conducted a descriptive secondary analysis of annually reported government expenditure on health-related long-term care between 2013 and 2022 from the UK Health Accounts data set. We contrasted this with UK governmental and non-governmental spending on specialist palliative care services using annual expenditure figures reported by Hospice UK. Results Real-terms UK government spending on health-related long-term care grew by £6.4 billion (22.9%) between 2013 and 2022, from £27.9 to £34.3 billion. Real-terms spending on specialist palliative care grew by £110 million (10.7%) over the same period, from £1027 to £1137 million. In 2022, spending on inpatient care comprised the majority of government health-related long-term care expenditure (£22.6 billion; 65.9%). Home-based care comprised one-third (£11.8 billion; 33.4%). Outpatient care accounted for 0.7% (£260.2 million). Equivalent data were not available for analysis of specialist palliative care expenditure. Conclusions Low granularity of UK national health expenditure accounts data limits national and international comparisons of spending on palliative care. However, it is clear that UK expenditure on specialist palliative care services has not kept pace with growth in expenditure on health-related long-term care.