Recommendation 20

The Department and NHS England agreed that there are gaps in provision of palliative and end of life care and that it must meet demand where it is needed.39 They also acknowledged the importance of moving care away from costly acute settings into the community, citing a dashboard that they use to track patients who are receiving care but may not need to be in hospital.40 Professor Murtagh told us that around 500,000 people die in England each year, and of these around 42% do so in hospitals, where many people do not want or need to be and which is typically more expensive than other settings. Some 28% die at home, which is where most people would prefer to be, while 21% die in care homes and 5% in hospices.41 She also highlighted the disproportionate flow of end-of-life funding that goes to the acute sector. On average, £22,000 is spent per person in the last year of their life, with 78% going to the acute hospital sector, approximately 5% to the hospice sector, and 4% to other partners in formal healthcare, including the ambulance service and district and community nursing.42 36 Q 6 37 Qq 12 and 24 38 Q 30 39 Qq 29, 38 and 80 40 Qq 34, 39 and 49 41 Professor Fliss Murtagh (AHE0020) 42 Q 5 14