Michael Simmons Michael Simmons

As the NHS shut down, the wealthy chose to die at home

Since January, some 22,000 more Brits have died at home than would be expected in a normal year. These so-called excess deaths at home had stumped doctors and left GPs calling for an investigation. The causes remain unclear but a study published today offers the first clues to what’s going on.

The study, funded by Marie Curie, found that deaths at home increased sharpest in the most affluent areas during the pandemic. While excess deaths occurred in all groups, in England there were 33 per cent more at-home deaths than pre-pandemic in the least deprived areas. Meanwhile, deaths in the most deprived areas grew just 21 per cent. In Scotland the increases were even starker: 44 per cent in the least deprived and 36 per cent in the poorest areas.

There has always been a gap in where the rich and poor die: wealthy areas are well served by at-home end-of-life care while poorer areas are left with resources focused around hospitals and hospices – with less choice for at-home care. This gap accelerated during the pandemic. While the well-off could spend their last days surrounded by loved ones at home, the poor were forced into hospitals in the middle of Covid outbreaks and draconian restrictions on visitors.

This poverty-related death gap was clearest between the first two Covid waves, a period where there were fewer virus deaths. The researchers say this suggests the change ‘may be sustained beyond the pandemic.’ The link between the surge in at-home deaths and less deprived areas wasn’t present when the study’s authors looked just at deaths caused by Covid. This means the change in where people die was not caused by Covid itself but by the restrictions put in place to tackle it and by the closing down of the health system.

In 2020, the period of the study, the NHS had effectively shut down anything non-Covid related.

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