‘Rapid acceleration’ in number of people dying at home with hospices reporting fewer inpatients

There has been a “rapid acceleration” in the number of people dying at home in the UK, with hospices delivering almost one million “hospice-at-home” services in 2020 and 2021, a report has found.

Analysis by the Nuffield Trust in conjunction with Hospice UK has revealed that more people are dying at home than ever before, with more than 100,000 extra deaths being recorded in a home setting over the last two years.

In contrast, hospice day services and outpatient settings saw a decline in people seen, and there were fewer hospice inpatients in the same period.

Hospices say they have had to adapt to this “rapidly accelerating” trend, which was first observed before the Covid pandemic began, and are calling for better data to be collected about hospice use across the UK so they can continue to provide the necessary end-of-life care.

Hospices provided end-of-life support throughout the pandemic, as well as delivering virtual welfare, bereavement and therapy services.

The report also found that despite a 4% drop in the number of people supported by hospices in 2020/21, which represents only a small decrease when compared to other health services during the pandemic, hospice and end-of-life care still faced significant disruption.

According to the findings, the needs of patients using hospice services appear to have become increasingly complicated, with greater demand from these patients for both in-patient end-of-life care and bereavement services.

Sarah Scobie, deputy director of research at the Nuffield Trust, said: “It’s so important we get end-of-life care right – for patients and their loved ones. The pandemic has been a difficult time and has rapidly accelerated changes to how hospice care is delivered.

“Services have adapted to reach the increasing number of people who need support from hospices in their own homes. But we need to know more about people’s experiences of that care and ensure that all areas have services which are properly supported to meet the needs for end-of-life care and sustain these changes as more people die at home.”

Craig Duncan, interim chief executive of Hospice UK, said: “This report shows that hospices continue to play a vital role in providing quality end-of-life care. Having adapted so quickly during the pandemic, hospices have been able to serve their communities and provided much-needed care for people and their families at a time when it was most needed.

“Hospices are often best placed to provide high-quality, holistic care for a dying person either in the hospice itself, or more commonly at home. The pandemic has only reaffirmed that hospices play a key role in ensuring that people get the best quality care and are able to die where they wish, with the support they need.

“More and more we have seen that hospice staff have been able to provide quality end-of-life care throughout the pandemic and beyond. As part of an increasingly integrated health and care system, hospices will continue to deliver important end-of-life care for their community into the future.”

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