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More patients dying in hospices but inequality gap grows

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The proportion of people dying in hospices in England has nearly doubled over the last 20 years, according to latest research.

However, the gap in hospice deaths between people living in the least and most deprived areas appears to be growing, found the study by the Cicely Saunders Institute at King’s College London. 

The study, published in the journal Palliative Medicine, examined almost 450,000 deaths from 1993-2012.

“People are dying at older ages, and increasingly from chronic conditions with long periods of decline”

Katherine Sleeman

According to its authors, it is the first study to use whole-population data to examine how hospice deaths have changed over time, and the factors related to hospice death.

Researchers found a steady increase in the annual number of hospice deaths from 17,400 in 1993 to 26,000 in 2012. This accounted for 3.4% of all deaths in England in 1993, and 6.0% in 2012.

The vast majority died from cancer, with just 5% of all deaths occurring in people with non-cancer diagnoses, although this proportion increased from 3.9% to 7.7% over the study period.

The study also found that people who died in hospice were more likely to be resident in affluent than deprived areas, and that this gap grew by 25% over the study period.  

Lead study author Dr Katherine Sleeman said: “The demographics of death are changing, and people are dying at older ages, and increasingly from chronic conditions with long periods of decline.” 

“It is clear that we have a long way to go to make sure that every dying person gets the care that they need”

Simon Chapman

She noted that the annual number of UK deaths was predicted to rise, and called on policy makers and practitioners to consider whether the current models of hospice care were “best suited to the changing needs of an ageing society”.

But she added: “It is concerning that trends suggest that when it comes to death in hospice, the gap between rich and poor is increasing. We must ensure that access to specialist hospice care is available to everyone.”

Simon Chapman, director of policy, intelligence and public affairs at the National Council for Palliative Care, said: “Whilst it is encouraging that more people have been able to die in hospices, it is clear that we have a long way to go to make sure that every dying person gets the care that they need.

“It is very concerning that people’s access to in-patient hospice care is so dependent on what diagnosis they have or whether they are rich or poor,” he said.

Dr Ros Taylor, national director for hospice care at the charity Hospice UK, noted that much care was now delivered “beyond the walls of a hospice building”.

“We suspect that the pattern of care in the community maybe different from those in hospice beds, reaching many more patients with illnesses other than cancer,” she said.

She added that Hospice UK was currently developing a new toolkit to help hospices better map the palliative care and end of life needs of people in their local communities.

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Readers' comments (1)

  • What about Nursing Homes Then ? Totally forgotten and ignored as usual. Nurses in Nursing Homes all over the Country have been delivering 24/7 Palliative Care for years.This sytem bye the way was set up by The LHA inspection teams
    and the Nursing Home Matrons and is still operating under the CQC

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