Research shows that around 20 terminally ill people in Britain die every day with unrelieved pain

An estimated 20 terminally ill people in Britain die every day with unrelieved pain, according to research by the independent Office of Health Economics (OHE).

According to the research, which will be presented to MPs on Tuesday, one in four people receiving palliative care in England have “unmet pain needs”. The OHE said it used “the most conservative estimates (suggesting) the actual number is likely to be much higher”.

It calculated that, even with the “highest possible standards of palliative care at hospice level”, more than 7,300 people would die with unrelieved pain in the UK in 2023. In 2019, the comparable figure was almost 6,400. people per year – an increase of 15% in four years.

It also said that fewer than 5% of terminally ill people in England who needed hospice care in 2023 received it.

The OHE’s findings will help intensify the debate over the legalization of assisted dying ahead of a historic vote by MPs on Friday. Supporters and opponents of Kim Leadbeater’s bill are making their last attempts to convince undecided MPs, with few willing to predict the outcome of the free vote.

Recent weeks have exposed divisions within the government over the issue, despite a call from Keir Starmer for ministers to remain neutral in the debate.

Two justice ministers are believed to be planning to vote in favor of assisted dying after Justice Minister Shabana Mahmood said at the weekend he was strongly opposed to the proposals.

Jess Phillips, the health minister, said she was “a person who fundamentally believes in people’s right to make a choice about their bodies”. But she defended Mahmood’s intervention, saying it was up to each individual MP to make their own moral choice.

Heidi Alexander, the Minister of Justice, is also said to be in favor of the bill and was previously chairman of the parliamentary group on end-of-life care.

The OHE said that regardless of the outcome of Friday’s vote, investments in high-quality end-of-life care must be a “critical part of the assisted dying conversation”.

The research supports assisted dying advocates’ argument that even excellent and comprehensive palliative care cannot guarantee a pain-free death and that all options should be available to terminally ill people.

Demand for palliative care in England increased by 15% between 2019 and 2023, from 378,427 to 436,022 patients. Between now and 2040, demand is expected to increase by a further 25%, the OHE said.

Prof. Graham Cookson, chief executive of the organisation, said: “Our research shows that even if we maintain the highest standards of care, there will remain a group for whom no form of pain relief will ease their suffering in the last few months of their lives.

“However, the reality is that there is a widening gap in access to palliative care, and this number is only expected to grow over the years, across all settings. The actual number of people dying from unrelieved pain in Britain is likely to be much higher than our conservative estimate.”

Mark Jarman-Howe, director of St Helena hospice in Colchester, Essex, said the palliative care sector needed to be fairer. Speaking in a personal capacity, he said: “I am a strong supporter of hospice and palliative care. It can be transformative for people, but it cannot possibly solve all the symptoms and all the pain at the end of life.

“At least 20 people die from pain every day in the UK, and that’s not including other unresolved symptoms such as uncontrollable nausea. Even if we have the best possible financing for hospice care, that would still be a problem we need to address.”

Rebecca Gillanders, a lawyer, said her mother’s “excellent” palliative care failed to reduce a capable, robust and positive woman “to a desperate, anguished creature” begging to die.

Gillanders’ mother was diagnosed with brain cancer a year ago and died two months later at the age of 69. “She was on the strongest drugs possible, but it took ten desperate, miserable, brutal days before she died. Her death was emblematic of the experiences that many people have behind closed doors.”