How many patients die from thirst or starvation?

9 January 2017
What was claimed

Two patients every day die of thirst or starvation in NHS hospitals.

Our verdict

Roughly one patient every three or four days died as a direct result of malnutrition or dehydration in NHS and non-NHS hospitals in England and Wales across 2015. This can’t be directly linked to the quality of care, though.

“NHS hospitals plunged into crisis as two patients die each DAY of thirst or starvation”

Sun, 9 January 2017

This isn’t entirely correct. The death of roughly one hospital patient every three or four days is directly attributed to malnutrition or dehydration. But around two patients each day are recorded as having malnutrition or dehydration as a secondary factor in their death.

The fatal malnutrition or dehydration might also be due to a patient’s condition, or have started before they reached hospital, rather than as a result of poor care once they were there.

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Underlying cause of death or a contributing factor?

As the Sun acknowledges later in its article, there were 40 deaths in hospitals in England and Wales in 2015 where dehydration was the ’underlying’ (main) cause. There were 59 deaths where malnutrition was the underlying cause.

That’s 99 deaths altogether across the year, or roughly one every three or four days.

Altogether there were 429 hospital deaths where dehydration was listed as any kind of factor and 297 where malnutrition was listed. This includes where it was an underlying cause of death or a contributing factor.

The Sun has added these figures, together with equivalent records from care homes, to get 856, or over two a day.

The Office for National Statistics gives a slightly lower figure that avoids double counting

ONS statisticians told us that some individuals’ deaths will be counted several times in the second set of figures if they suffered from more than one of the conditions listed. So we can’t just add up the mentions of dehydration and mentions of malnutrition to get a figure for the number of deaths involving either one of these factors.

That said, removing double counting doesn’t change the picture that much. The ONS has clarified that 828 individual deaths in 2015 were associated in some way with malnutrition or dehydration in hospitals and care homes. In hospitals alone it was 711 deaths. That’s just under two a day on average.

And the final figures may be a little higher, as the ONS says that they only include deaths which were registered up to 31 December 2015. Any deaths occurring in 2015 which were registered after this date will not be included.

It doesn’t necessarily mean poor levels of care

The ONS says that the figures don’t “provide enough information to link the deaths to poor care, either in the hospital or in the care home. It is not possible to determine from these figures how or where the condition originated.”

It also points out that the malnourishment or dehydration might be linked to a condition that affected the patient’s digestion, such as cancer in the digestive system; or “the deceased may have been malnourished before they went into hospital”.

That’s not to say that there aren’t any such deaths that are attributable to poor care—just that not all of the deaths recorded in these figures are necessarily the result of an NHS failure.

One in eight feel patients don’t receive enough assistance with eating

The ONS has looked into how care is provided to patients based on how well friends and relatives think they were looked after in the last days of their life.

The survey, covering England only, found that 75% agreed that support was provided by health professionals to help the patient eat, while 13% disagreed. 78% of those asked agreed that support was provided to drink while 12% disagreed.

A note of caution

The ONS also points out that the definition of “hospital” doesn’t just include those run by the NHS. It also covers military hospitals and privately-run hospitals.

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