Project #34:
Deaths at home during Covid-19 and implications for patients and services.

The Covid-19 pandemic has seen a huge shift in where patients are dying, in addition to increased mortality overall. While the majority of patients who died from Covid-19 did so in hospitals or care homes, between March 2020 and July 2021 a third more people than usual died at home, largely from causes other than Covid-19. At the same time, services for people at the end of life were severely disrupted, with many services shifting to remote working as far as possible. This impacted how much support patients and families received to care for people in their own homes.

This study will use data from GP and hospital records, and data on registered deaths to:

• Understand what services were provided to patients who died over the course of the pandemic, compared with pre-pandemic, and how did service use vary between sub-groups of patients? This will include considering place and cause of death, demographic, social and clinical factors.
• Develop measures of quality of end of life care from the data, taking account of the quality of the data available. We will use published standards on quality of care, for example, guidance from NICE, to identify potential measures of quality which could be identified from the data.
• Develop questions for future research, once we have identified which measures of quality of care are feasible to assess from the data.

The shift in place of death during the pandemic, and the exacerbation of existing health inequalities and pressures on health and care services, make this an even more important policy area to address now.