While deaths in hospitals and care homes were the focus of attention during the peak of the Covid-19 pandemic, by the beginning of June deaths in these settings had returned to, or fallen below, the average compared with the previous five years.
In contrast, there have continued to be 'excess' deaths at home, with on average 750 excess deaths a week in this setting over the last three months.
The lower-than-usual number of hospital deaths during the last three months suggests that patients are dying at home who might previously have been admitted to hospital. This could reflect patient and family choice – for example, in response to hospital visiting restrictions. More worryingly, people may feel deterred from seeking medical help because of fear of catching Covid-19 in hospital. Only 2% of deaths at home in 2020 have been recorded as Covid-19 related, but whether some of these deaths could have been avoided if people had received care in hospital is unknown.
Additionally, some deaths may be occurring at home among people who might previously have been admitted to a care home. Although data is patchy, there are reports that care home occupancy is lower than usual and that people are avoiding care home admissions due to concerns about Covid-19 risks. Over the last three months there have been around 100 fewer deaths in care homes than would be expected from the average.
Whatever the reasons for the greater number of deaths at home, a third more people are now dying at home than prior to the pandemic. Although it is widely thought that many people prefer to die at home, this shift presents a significant challenge for community health and care services to deliver high quality care for patients, and to support families at the end of life.