Official Statistics

Statistical commentary: End of Life Care Profiles, February 2018 update

Published 6 February 2018

New in this update

New mortality data for 2016 has been added to the End of Life Care Profiles for local authorities.

The following indicators for age groups 0 to 64, 65 to 74, 75 to 84, 85 and over and all ages have been updated:

• percentage of deaths occurring in hospital
• percentage of deaths occurring in care home
• percentage of deaths occurring at home
• percentage of deaths occurring in a hospice
• percentage of deaths with an underlying cause of cancer
• percentage of deaths with an underlying cause of circulatory disease
• percentage of deaths with an underlying cause of respiratory disease

Main findings

This update shows:

• in 2016, almost half of all deaths in England (46.9%) occurred in hospital
• nearly a quarter of deaths (23.5%) occurred in people’s own home
• 21.8% of deaths occurred in care homes, that is residential and nursing homes
• 5.7% of deaths occurred in a hospice
• the trend over recent years has been a reducing proportion of deaths in hospital, and an increasing proportion of deaths to occur in care homes and private homes. In 2004, 57.9% of deaths occurred in hospital
• there is considerable variation across the country by district and local authority, in 2016 the proportion of deaths in hospital ranged from 34.2% and 63.1%
• the recent trend in underlying cause of death includes a continuing reduction in the proportion of deaths due to circulatory disease.

Summary

Place of death

In 2016 46.9% of people died in hospital, 21.8% in care homes, 23.5% at home, 5.7% in hospices (Figure 1).

Between 2004 and 2016 the percentage of deaths in hospital fell by 11% from 57.9% to 46.9% (Figure 2).

The percentage of deaths at home, in care homes and in hospices increased between 2004 and 2016; home deaths by 5.1%, care home deaths by 5.3% and hospice deaths by 0.9%. Compared to 2015 the percentage of deaths in care homes in 2016 fell by 0.8%. During the same time period, the percentage of deaths in homes and hospices increased by 0.7% and 0.1% respectively.

Figure 1: Percentage of deaths (persons, all ages) in hospital, care home, home and hospice, England, 2016

Place of death varies by age at death. Over half of deaths (50.5%) for persons aged 75 to 84 were in hospital. 36.7% of deaths in people aged 85 and over occurred in care homes. 33.9% of persons aged 0 to 64 and 30.3% of those aged 65 to 74 died at home compared to 16.4% of people aged 85 and over. 10.4% of people aged 0 to 64 and 10.0% of people aged 65 to 74 died in hospices compared to 2.1% of people aged 85 and over.

In 2016, the proportion of deaths in hospital varied from 34.2% to 63.1% by Local Authority District and Unitary Authority areas. The proportion of deaths in care homes varied from 5.2% to 35.8%. The proportion of deaths at home varied between 16.5% to 32.5% and hospice deaths from 0.2% to 14.3%.

Figure 2: Percentage of deaths (persons, all ages) in hospital, care home, home and hospice, England, 2004 to 2016

Cause of death

In 2016 cancer accounted for 28.0% of deaths in England, circulatory disease 25.5%, and respiratory disease 13.7% (Figure 3).

Cause of death varies with age at death. Cancer accounts for 44.1% of deaths in persons aged 65 to 74 years compared to 15.6% of deaths in people aged 85 and over. The percentage of deaths from circulatory and respiratory disease increase with increasing age. Circulatory disease accounts for 20.0% of deaths in persons aged under 65 compared to 27.8% of deaths in people aged 85 and over. Deaths from respiratory disease account for 7.7% of deaths in people aged under 65 and 15.4% of deaths in people aged 85 and over.

Between 2004 and 2016 the percentage of deaths from circulatory disease fell by 11.7% from 37.2% in 2004 to 25.5% in 2016. (Figure 4). The percentage of deaths from cancer increased from 26.3% to 28.0%. The percentage of deaths from respiratory disease was 13.6% in 2004 and 13.7% in 2016.

Within Local Authority District and Unitary Authority areas the percentage of deaths from cancer ranged from 21.3% to 33.2%. For circulatory disease values ranged from 20.1% to 38.4% and for respiratory disease 9.9% to 19.0%.

Figure 3: Percentage of deaths (persons) by age group from cancer, circulatory disease and respiratory disease, England, 2016

Figure 4: Percentage of deaths (persons, all ages) from cancer, circulatory disease and respiratory disease, England, 2004 to 2016

Background and further information

The End of Life Care Profiles aim to improve the availability and accessibility of information around end of life care. The profiles provide a snapshot overview for various geographies in England. They are intended to help local government and health services improve care at the end of life.

The website contains data for Upper Tier Local Authorities, former Government Office regions, England together with Lower Tier Local Authorities and Clinical Commissioning Groups.

Providing care at the end of life often involves the interaction of many different care agencies. The profiles will help commissioners and providers to get a clearer picture of the end of life care needs of their local populations. These will help with the planning and delivery of services and will support local drives towards improving end of life care.

The data has been extracted using the Office for National Statistics (ONS) annual mortality and population statistics. Further details about the profile methodology are available within the definitions section of the online version of the profile.

View the End of Life Care Profiles

Responsible statistician, product lead: Andy Pring, Julia Verne
For queries relating to this publication, please contact: neolcin@phe.gov.uk