The pandemic led to major disruption to services right across health and social care, as well as a huge shift in where patients are dying, with more than 105,000 extra deaths at home in the UK over the first two years of the pandemic. The reasons for this are not fully understood, but have profound implications for the experience of people dying and their families and carers, and for the type and quality of care they receive.
There is currently a large gap in our understanding of the services that the hospice sector provides across the UK. This report by the Nuffield Trust seeks to begin to close that gap by analysing the important role of hospices in supporting people at the end of life and their families, both in hospice settings and at home.
Key findings include:
- In 2020/21, hospices supported an estimated 300,000 people in the UK, including people at the end of life, families, carers and bereaved relatives.
- During the pandemic there has been a shift in where and how services are provided, with much more care delivered at home. In 2020/21, there were almost a million ‘hospice at home’ contacts. In contrast, day services and hospice outpatient settings saw a decline in the number of contacts and people seen, and fewer people were hospice inpatients.
- In addition, the complexity of patients’ needs may have increased, with patients receiving inpatient care having more contacts each, and contacts per person for bereavement services also increasing.
- In 2020/21, more than 120,000 community support contacts were delivered virtually, along with virtual welfare, bereavement and therapy services. Hospices switched to providing services remotely, to respond to concern from patients about attending appointments and to reduce the risk of Covid-19 infection.
- In 2020/21, there was a drop in the number of people who hospices supported but this was small, particularly when compared to the significant falls in activity across other health services during the pandemic.