The proportion of people dying in hospitals in England has decreased over the past 10 years, while deaths at home or in care homes have increased, according to new analysis of official data.
Public Health England, which collated the data, claimed that the trend indicated that end of life care was improving because previous research has shown the vast majority of people would like to die out of hospital.
“We are now a step closer to balancing out the number of people using hospital and community care”
Mortality data from 2013 shows 44% – 207,764 – of deaths were at home or in a care home, compared to 35% – 166,749 – in 2004.
In particular, deaths at home have increased from 18% in 2004, to 22% in 2013.
The proportion of people dying in hospitals has dropped, from 57% in 2004 to 48% in 2013, meaning a reduction of 50,000 deaths in this setting over nearly 10 years.
Previous surveys have found the preferred place for dying is at home, with the government’s 2013 National Survey of Bereaved People finding that 79% of wanted to die in this setting, 8% in a care home and 3% in hospital.
PHE’s National End of Life Care Intelligence Network – which led the data analysis that it collated along with recent research and evidence in its report What We Know Now 2014 – said the NHS was now “a step closer” to achieving a more even spread of people receiving end of life care in and out of hospital.
“Inclusion of death and dying in undergraduate training could help to change the current culture that considers death to be a medical failure”
Professor Julia Verne, clinical lead at PHE’s National End of Life Care Intelligence Network, said: “It is of course appropriate for some patients to die in hospital but this year’s findings are encouraging as our understanding of what patients want continues to improve.
“There is still work to be done to ensure we keep focus, not just on the numbers but on people’s experience of dying,” she said. “However we are now a step closer to balancing out the number of people using hospital and community care.”
The report also pointed to end of life care training gaps for nurses and doctors identified in a report by the Royal College of Physicians in 2014, called the National care of the dying audit for hospitals, England.
It found that while more than 80% of trusts had provided some form of training in this area in the previous year, it was only mandatory for nurses in 28% of trusts and in 19% for doctors.
“Inclusion of death and dying in undergraduate training could help to change the current culture that considers death to be a medical failure,” stated the PHE report.
It also highlighted research that found people’s top priority when dying was to be pain free, but that pain management was reported by bereaved relatives as being at a significantly lower level for patients at home compared to other settings.