BLOG SERIES - Dramatic increase in deaths at home - No.6

In the graph above, we can see that the number of deaths due to all causes in 2021 (solid red line) in the past few weeks was similar to the numbers this time last year (faint red line), which is still well above the numbers in the 2015-2019 period. Only very few of these deaths were covid-related, as can be seen from the small gap between the red (all cause deaths) and blue lines (non-covid deaths). It is looking increasingly likely that this trend will continue, particularly in light of the number of deaths in hospital and care homes having returned to levels similar to the pre-pandemic period in the past few weeks.

Data up to the start of August 2021 demonstrate that more than one in three of all deaths (34.4%) in Scotland happened in people’s own homes or other non-institutional settings (excluding care homes, for example). That figure is up from 31.9% in 2020 which was itself a higher figure than in previous pre-pandemic years. Hospital deaths in 2021 so far represent 45.9% of all deaths, up from 43.1% in 2020. The proportion of deaths in care homes is at its lowest since 2015, at 19.3%, whereas the proportion of deaths at home is at its highest level.

Implications and Next Steps

The sustained increase in home deaths since the start of the pandemic will very likely have had implications for palliative care provision. Better understanding the shift is important to inform planning of future care and end-of-life strategies, considering both where and how care is provided. 

In response to our findings, we are finalising details of a project application to use health data to investigate the health service use of people who died at home during the pandemic. This aims to enhance our understanding of the increase in home deaths and the circumstances of such deaths through linking administrative data collected by the NHS and National Records of Scotland (NRS).