One in three people who die in hospital could spend their final days at home

As many as one in three people who die in hospital could spend their final days at home or in more appropriate care settings, but only if the government is prepared to increase investment in community-based health and social care, according to a new report from the Institute for Public Policy Research think-tank (IPPR).

End of Life Care in England says that increased investment in long-term care outside hospitals in England could enable many more people to spend their last days and weeks at home, or in a more suitable setting.

Last year, 47% of deaths in England took place in hospital, compared to 28% in a care home and just 23% at home. However, 60% of people who experience poor quality care do so in a hospital setting and, provided care at home is adequate, most would prefer to die there.

IPPR’s Jack Hunter has called on Jeremy Hunt to set out a “radical and sustainable” financial settlement for health and care to ensure more people are get the right care, in the right place for them.

End of Life Care in England also finds a correlation between poverty and the likelihood of dying in hospital, with those living in deprived areas being 15 per cent more likely to die in hospital.

IPPR Research Fellow Jack Hunter, co-author of End of Life Care in England said:

“For too many people, the end of life is an even more difficult experience than it needs to be. The fact that those living in the most deprived areas are more likely to die in hospital is wholly unjust. Where you live should not affect whether you experience good quality care at the end of your life.

“Enabling more people to spend the end of their lives outside hospitals, in more appropriate settings, with properly funded support in place, will improve their experience of care. It will also be more cost effective for the taxpayer.

“With a forthcoming green paper on care and support for older people, Jeremy Hunt has the opportunity to set out a radical and sustainable solution for how we fund quality health and care in this county. He should not pass it up.”

ENDS

CONTACT

For further details about End of Life Care in England please contact IPPR Head of News and Communications David Wastell on +44 (0)7921 403651 or email D.Wastell@ippr.org

NOTES

IPPR research fellow and health expert Harry Quilter-Pinner is available for interviews.

The full report End of Life Care in England is available at: https://www.ippr.org/research/publications/end-of-life-care-in-england

The report marks the beginning of a major programme of work looking at end of life care, by the Centre for Health Policy, Imperial College London, the University of Lausanne in Switzerland, the University of Edinburgh and IPPR, supported by the Health Foundation.

End of Life Care in England recommends that:

1. The government, NHS organisations and Health Education England should consider ways to encourage the NHS workforce to have meaningful conversations about death and dying with those at the end of life, their families and carers.
2. The Government should consider how to drive integration of health and care commissioning and provision at the local level and at pace, including through further devolution.
3. The Government should consider how it will incentivise the NHS to shift towards more primary and community care, as well as determining a radical and realistic financial settlement for social care.

IPPR recently published the interim report of the Lord Darzi review of Health and Care, which suggested that returning the NHS to its long term funding growth will require a £50bn year-on-year increase in annual expenditure. Adult social care will also require an extra £10bn minimum per annum by 2030 just to maintain the existing system.

The Government is currently preparing a green paper on care and support for older people by summer 2018. The paper will set out plans for how government proposes to improve care and support for older people and tackle the challenge of an ageing population. Jeremy Hunt has said that the green paper will “jump start” a debate with the public about how social care should be funded in the future.

End of life care refers to care for patients who are in the last stage of their lives, including those with advanced, progressive, incurable illnesses. It includes the management of pain and other symptoms, as well as psychological, social, spiritual and practical support for both patients and their families throughout the last phase of life and after death.

IPPR (the Institute for Public Policy Research) is the UK’s pre-eminent progressive think-tank. Find out more at ippr.org