Palliative Care and End of Life

This topic area covers statistics and information relating to palliative care and end of life in Hull including local strategic need and service provision. Further information is available on Causes of Death under Population, and for specific diseases and medical conditions under Health Factors under Adults.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• The aim of palliative care and end of life services is to enable patients with advancing progressive life limiting illness to be cared for and to die in their preferred place of care with optimal pain and symptom management, supported by skilled staff.
• In 2024/25, 1,160 (0.4%) patients registered with Hull GPs were recorded as requiring palliative care which was lower than England (0.6%) and across Humber and North Yorkshire Integrated Care Board (0.7%).
• In 2024, just under half (48%) of deaths among Hull residents occurred in hospital, just over one-quarter occurred at home (26%), 16% in care homes, 6.8% in hospices and 3.6% in other places.
• The majority of people aged 65-84 years were more likely to die in hospital than other age groups. Not surprisingly, few people aged under 65 years died in a care home (2.6%) but the percentages more than doubled for those aged 65-74 years (to 6.8%) and more doubled again for those aged 75-84 years (to 14%) and almost one-third (32%) of people aged 85+ years died in a care home.
• The percentage of people dying in hospital has shown a small decrease over time with dip in the percentage during the COVID-19 pandemic with fewer deaths occurring in hospital during 2020. The percentage of people dying in a care home remained relatively constant prior to the pandemic, but increased during 2020, and has since fallen, but the trends over time differed depending on the age at death.
• The percentage of deaths that occurred in a care home that were among temporary residents of a care home has increased since 2019 although the percentages increased between 2019 and 2022 with relatively small changes in the percentage between 2022 and 2024.
• The percentage of deaths that occur at home has increased slightly over time, although differs substantially among the groups with fewer older people dying at home (18% among 85+ years compared to 37% among under 65s).
• The percentage of deaths that occur in a hospice remained around 5-6% between 2015 and 2019, but decreased to around 4% for 2020 and 2021 due to the COVID-19 pandemic. The percentage has since increased and for 2024 is the highest it has been at 6.8%. The percentage does differ with age of death though with fewer people aged 85+ years dying in a hospice (2.9%) compared to those aged 65-74 years (10.5%).
• Around 2% of deaths among those aged 65+ years occurred in other places, but this was higher among those under 65 years with one in ten deaths occurring in other places. This has increased though as it was 6-8% between 2015 and 2019 falling to a low of 5.8% in 2020, before increasing to over 7% for 2021 and 2022, to 8% for 2023, and to 10.3% for 2024.
• For 2023-24, Hull has the lowest percentage of deaths from heart failure that occurred at home or at the deceased usual residence (35%) compared to other local authorities in the region (61%) and England (60%). One in ten deaths from chronic obstructive pulmonary disease occurred in care homes, 62% in a hospital and 23% at home which was slightly different to England (12%, 56% and 29% respectively).
• In 2025, Hull had the highest rate of care home beds per 100 population aged 75+ years (11.5) across the the local authorities in the region so was lower than the regional average (8.8) and also higher than England (8.3). However, the number of nursing home beds per 100 population aged 75+ years was considerably lower in Hull (2.5) compared to the regional average (3.5) and England (4.0). This could influence where deaths occur.
• In 2024, around one in fifteen (6.8%) had three or more emergency hospital admissions within the last three months or their life among those aged under 75 years, but this was less at around one in 18 (5.6%) among those aged 75+ years. There could be many reasons why this is the case, but it is possible that this is – in part – associated with a higher percentage of the population aged 75+ years living in a care home, and pre-existing medical conditions managed within primary care.
• There is a need to work with partners to ensure that palliative and end of life care services are integrated, high quality and accessible in ways that offer people appropriate choices.

The Population Affected – Why Is It Important?

The aim of palliative care and end of life services is to enable patients with advancing progressive life limiting illness to be cared for and to die in their preferred place of care with optimal pain and symptom management, supported by skilled staff. It is generally recognised that too many people die in hospital and that this might not be their preferred place of death, and a proportion of these people might prefer to die at home provided that the right care is in place.

Around 1% of the population of the UK dies each year (over half a million). A quarter of all deaths are due to cancer, a third from organ failure, a third from frailty or dementia, and only one twelfth of patients have a sudden death. The considerable benefits of identifying patients in need of palliative care include providing the best health and social care to both patients and families and avoiding crises, by prioritising them and anticipating need. Identifying patients in need of palliative care, assessing their needs and preferences and proactively planning their care, are the key steps in the provision of high quality care at the end of life in general practice.

The number of patients requiring palliative care can be examined from data collected as part of the Quality and Outcomes Framework within primary care. Quality of care indicators are also included which relate to having regular multidisciplinary meetings where the team can ensure that all aspects of the patient’s care has been assessed and future care coordinated and planned proactively to ensure that the patient has the best end of life care. Local analysis of the QOF data has been completed with prevalence calculated for each GP practice and Primary Care Network group.

The Hull Picture

Numbers Requiring Palliative and End of Care Support

In 2024/25, there were 1,160 patients registered with Hull GPs who were recorded as needing palliative care which represented 0.4% of Hull’s patients (03F) and it is lower than England (0.6%) and other areas within Humber and North Yorkshire (range 0.6% to 1.5%).

The percentage of patients recorded as needing palliative care among patients registered with Hull GPs has remained relatively constant in Hull at 0.3% between 2012/13 to 2022/23 although the total numbers have increased slightly over time with the percentage increasing to 0.4% for the last two years.

From the local analysis of the national Quality and Outcomes Framework datasets, there was no statistically significant association between average age of the practice patients and the percentage of patients requiring palliative care across the 25 practices in Hull for 2024/25. There was also no statistically significant association between the percentage of patients requiring palliative care and the average deprivation score of registered patients (using the Index of Multiple Deprivation 2025). Further analysis including the percentage requiring palliative care for each practice is available within the file within Local Analysis of Quality and Outcomes Framework Data.

Number of Deaths by Location of Death

The Office for Health Improvement & Disparities’ Fingertips also presents information on the percentage of deaths which occur at different locations by age of death.

The figures relating to 2020 and 2021 will be severely affected by the COVID-19 pandemic. From initial local analyses of mortality data, people who died in 2020 from COVID-19 were more likely to die within a care home (30%) or hospital (63%) and much less likely to die at home (5%) compared to all deaths which occurred during the five year period 2015-19 (19%, 49% and 23% respectively), although people who died of non-COVID-19 conditions in 2020 were more likely to die at home (29%) or in a care home (22%) and less likely to die in hospital (41%). Location of death also differed throughout 2020 and early 2021 during as response to the COVID-19 pandemic changed. It is also possible that bed capacity also changed over time, and could have influenced where the death occurred.

The information is presented for sub Integrated Care Boards and Hull is denoted by the code 03F.

Location of All Deaths

During 2024, just under a half of all deaths occurred in hospital for Hull patients (03F), just over one-quarter at home and 16% in care homes with 6.8% occurring in hospices and 3.6% occurring in other places.

Compared to England, fewer deaths in Hull occurred at home and in care homes, and more deaths occurred in hospital, hospices and in other places.

Deaths Occurring in Hospitals

For 2024, there was a higher percentage of deaths which occurred in hospital in Hull (03F) both overall and for those aged 65+ years compared to England.

Around half of all deaths occurred in hospital between 2015 and 2018, but this fell to a low of 44% in 2020. This could be influenced by the COVID-19 pandemic as more people died in care homes and at home during 2020, however, the percentage in 2019 was 48% so it is possible that the percentage was already decreasing due to changes in policy in 2019. Since the low of 44% in 2020, the percentage increased to 48% in 2021, and has remained relatively unchanged since then.

Of the 2,622 deaths in 2024, 1,256 occurred in hospital.

Slightly fewer deaths occur in hospital among those aged 85+ years compared to other older age groups. The percentage has generally been between 42% and 48% with a decrease in 2020 and 2021 likely associated with the COVID-19 pandemic, although the percentage in 2019 was also relatively low compared to 2018 so it is possible part of the reduction was due to other changes in policy prior to the pandemic. If this was the case, the changes have not been sustained as the percentage for 2024 at 45.8% is similar to what it was between 2015 and 2018.

The percentage in 2024 is the highest it has been since before the pandemic, but in England the percentage has decreased over this time period.

The percentage of deaths that occur in hospital among those aged 75-84 years has decreased slightly from 53% in 2014 to 50% in 2024. The percentage was much lower in 2020 likely associated with the pandemic, although the percentage in 2021 appeared to follow the same trend observed prior to the pandemic.

There has been slightly more year-on-year variability among those aged 65-74 years in relation to the percentage dying in hospital. Whilst the percentage was relatively low for 2020, the percentage at 50% did not stand out in relation to other years as there were other years between 2014 and 2023 that had similar percentages or even lower percentages.

Among those aged under 65 years, the percentage of people dying in hospital has varied between 42% and 52% with year-on-year variability with the latest year of 2024 having the lowest percentage at 42%.

Deaths Occurring at Care Homes

For 2024, 35% of all deaths in care homes for Hull (03F) were among people whose usual place of residence was not a care home, although this was higher for England at 41%.

The indicator relating to temporary residents relates to cases where the place of death is a care home, but that care home is not their usual place of residence, and this is given as a percentage of all care home deaths.

It is possible that patients leaving hospital who need extra support temporarily could be placed in a care home, and they might have a higher mortality rate (compared to those already living in a care home) having been relatively recently discharged from hospital.

Overall, compared to England for 2024, the percentage of deaths which occur in a care home was lower in Hull. For all ages combined, 15.5% of deaths occurred in a care home in Hull compared to 21.5% for England.

Not surprisingly, as people are more likely to live in a care home as they get older, the percentage who die in a care home increases with age.

In 2019, 29% of all deaths in care homes were among temporary residents whose usual place of residence was not a care home. The percentage fell slightly to 27% in 2020, but it is possible that the COVID-19 pandemic had an impact on this percentage. The percentage has increased to 32% in 2021 and to 37% 2022, although remained relatively unchanged between 2022 and 2023, before decreasing slightly to 35% for 2024.

Overall, 142 deaths occurred to people who were temporary care home residents out of the 406 deaths among people who were temporary or permanent care home residents.

The percentage of deaths which occur in care home increased in Hull between 2011 and 2012, but has remained relatively static at around 20% or just under between 2012 and 2019.

The rate increased between 2019 and 2020 from 19.8% to 22.6% due to the COVID-19 pandemic. People who died during 2020 were more likely to die in a care home and this was the case for deaths from COVID-19 and other conditions.

The percentage reduced to 18.5% in 2021 and further reduced to a low of 15.5% for 2024.

Of the 2,619 deaths in 2024, 406 occurred in a care home.

The percentage of deaths that occur in a care home among people aged 85+ years was around 34% to 35% prior to the pandemic although the percentage in 2019 was slightly higher at 38%. The percentage increased to 41% during the initial phases of the pandemic and remained relatively high at 38% in 2021. The percentage has subsequently decreased to 32.2% for 2024 which is the lowest percentage since at least 2015.

Between 2015 and 2019, the percentage of deaths that occur in a care home among people aged 75-84 years was around 18% to 20% prior to the pandemic but increases to 25% in 2020. The percentage has reduced since then and the percentage in 2024 at 14% is the lowest it has been since 2015.

The percentage of deaths that occur in a care home among people aged 65-74 years varied between 7% and 9% between 2016 and 2022, but the percentage in 2023 is the lowest it has been since 2015 at 5.6%, although the percentage increased slightly to 6.8% in 2024.

The percentage of deaths that occur in a care home among people aged under 65 years is low and has generally been 2-3%.

Deaths Occurring at Homes

During 2024, there was a lower percentage of deaths which occurred at home in Hull (03F) compared to England overall for all ages and this was particularly the case among people aged 85+ years, but the percentages were slightly higher in Hull among under 65s.

The percentage of people who die at home is higher among the younger ages.

The percentage of deaths which occur at home has been steadily increasing in Hull for all ages. Whilst the relatively large increase between 2019 and 2020 occurred – at least in part – of the COVID-19 pandemic, the increase has been maintained, although there has been a marginal decrease in the last two years.

In general, there has been an increasing trend in the percentage of people dying at home over time among those aged 85+ years which increased from 13% in 2014 to 20% in 2022, although this has decrease to 18% in 2024.

Among those aged 75-84 years, there has also been an increase in the percentage of people dying at home over time, although the increase is smaller than the increase observed for people aged 85+ years. Furthermore, the percentage has remained relatively unchanged in the last 2-3 years with around one-quarter dying at home.

Between 2016 and 2020, among those aged 65-74 years, there has been an increase in the percentage of people dying at home over time from around 25% in 2015 to a high of 35% in 2022, although there has been a decrease to 27% in 2024.

Among those aged under 65 years, a decade ago 32% were dying at home, but this has increased slightly to 37% in 2024. The percentage was higher at 40% in 2020 due to the pandemic.

Deaths Occurring at Hospices

During 2024, the percentage of deaths which occurred at a hospice was higher in Hull (03F) compared to England overall (6.8% versus 5.5%) and for those aged 65+ years. The percentage in Hull was lower than England among those aged under 65 years.

Around 5-6% of all deaths in Hull occurred in a hospice between 2014 and 2019, with a decrease to around 4% for 2020 and 2021 which is likely associated with the COVID-19 pandemic. The percentage has subsequently increased and is the highest it has been since 2015 at 6.8% for 2024.

In general, there has been a slight increase in the percentages of deaths occurring in a hospice among those aged 75+ years and a decrease among those aged under 75 years, although the percentages tended to be different for 2020 and 2021 due the pandemic.

Deaths Occurring at ‘Other Places’

The percentage of deaths which occur at ‘other places’ (not in hospital, a care home, the person’s own home or in a hospice) was small. The percentages differed by age and were around 2% of less among those aged 65+ years.

The percentage of deaths that occurred in other places was much higher among those aged under 65 years where external causes of death account for a higher percentage of the overall deaths among this age group. In 2024, one in ten deaths among under 65s occurred in other places.

The number of deaths that occur in ‘other places’ is relatively small and subject to year-on-year variability. The percentages have not differed substantially over time for those aged 65+ years, but have increased among those aged under 65 years.

The absolute number of deaths that occurred in other places among those aged under 65 years has doubled from 29 deaths in 2015 to 60 deaths in 2024. The percentage has increased from 6.4% to 10.3% over the same time period.

Location of Death by Cause of Death

Heart Failure

Information is also given on the percentage of deaths from heart failure which occur at home or at the deceased usual residence. The percentage in Hull is considerably lower than England for the two-year period 2023-24 (35.4% versus 59.9%).

Just over half of all heart failure deaths in Hull occurred at home or their usual place of residence for 2012-13 (54%), but this has steadily decreased to 35% for 2023-24.

A significantly lower percentage of people with heart failure die at home or their usual place of residence in Hull compared to England. Many factors could influence this which might include patient choice, family support mechanisms and facilities at home (for example, making room for medical equipment or having a downstairs toilet in the home etc).

Chronic Obstructive Pulmonary Disease

The percentages of deaths from chronic obstructive pulmonary disease (COPD) that occur in care homes, hospital and at home is also available on Fingertips. For 2024, slightly more chronic obstructive pulmonary disease deaths occurred in hospital in Hull (03F) compared to England, but fewer chronic obstructive pulmonary disease deaths occur in a care home or at home.

The percentage of deaths from chronic obstructive pulmonary disease deaths that occur in care homes has been variable in Hull ranging from 8.6% to 16.2%, although the percentage has been around 11% in the last four years.

The percentage of deaths from chronic obstructive pulmonary disease deaths that occur in hospital has been around 62% between 2012 and 2019, but reduced to 53% in 2020 which was likely associated with the COVID-19 pandemic. The percentage has been gradually increasing between 2020 and 2024 and is similar to what it was previously at 61.5% for 2024.

The percentage of deaths from chronic obstructive pulmonary disease deaths that occur at home was around 22% prior to the COVID-19 pandemic, although there were some years where the percentage was much higher or lower. The percentage increased sharply in 2020 and also increased further in 2021 due to the pandemic. Between 2021 and 2024, the percentage has decreased from the high of 33% in 2021 to 23% in 2024.

Number of Care and Nursing Beds

For 2025, Hull has the highest rate of care home beds per 100 people aged 75+ years across the region, but among the lowest number of nursing beds per 100 people aged 75+ years. This could influence where deaths occur.

The number of care home beds per 100 people aged 75+ years has decreased from 14.0 to 11.5 beds per 100 people between 2016 and 2024. There have also been decreases for England and across the region.

The rate has been consistently much higher in Hull compared to England and the region.

In contrast, the number of nursing home beds has been consistently much lower than England since 2016. There were 4.3 nursing home beds per 100 people aged 75+ years in 2016, but this has fallen to a low of 2.0 nursing home beds per 100 people aged 75+ years in 2024, although the rate has increased to 2.5 nursing home beds per 100 people aged 75+ years for 2025.

Emergency Hospital Admission In Three Months Prior to Death

There is also information on the number of patients who have three or more emergency admissions to hospital within the last three months of their life.

In 2024, the percentage of deaths with three or more emergency admissions within the last three months of their life was significantly lower among those aged under 75 years in Hull (03F) compared to England, but similar for those aged 75+ years.

Among those aged under 75 years, just one in 15 (6.8%) had three or more emergency hospital admissions within the last three months or their life, but it was lower at around one in 18 (5.6%) among those aged 75+ years. There could be many reasons why this is the case, but it is possible that this is – in part – associated with a higher percentage of the population aged 75+ years living in a care home, and their medical conditions are managed within the care home in conjunction with primary care as well as the different causes of death (and management of those conditions if applicable) among those aged under 75 years and 75+ years. The percentages were consistently lower among people aged 75+ years compared to those under 75 years for other sub Integrated Care Board areas.

The percentage with three or more emergency admissions within the last three months of life had been increasing for all ages from 7.4% in 2015 to 10.5% in 2019 before falling to 7.2% for 2020 with the fall likely associated with the COVID-19 pandemic. However, the rate has further decreased subsequently and is now among the lowest it has been at 6.1% for 2024.

Over the same period, the percentage had also increased for those aged 75+ years from 6.9% in 2015 to 9.8% in 2019, before falling in 2020 to 6.3%, and falling further to 5.0% in 2021 and then remaining around 5%, although for 2024, the percentage is slightly higher at 5.6%.

For those aged under 75 years, there has been a little more year-on-year variability between 2015 and 2019 with the percentage with three or more emergency admissions in the 90 days prior to death ranging from 8.3% to 12.8%. The percentage was around 9% between 2020 and 2022, but has fallen further to 6.6%-6.8% for 2023 and 2024.

Strategic Need and Service Provision

There is a need to work with partners to ensure that palliative and end of life care services are integrated, high quality and accessible in ways that offer people appropriate choices. There is a need to work with partners to promote self-care and mutual support in community settings including hospices and the patient’s home so this is viewed as the norm and reduce reliance on residential or care homes. There is a need to reduce inappropriate hospital admissions and to ensure robust and effective “wrap around care” covering 24 hours and to focus on earlier advance care planning which respects individual needs and allows for people’s cultural and religious preferences. Advice and support needs to be timely, and advice and support around other areas which can cause stress, such as housing and benefits, would be of benefit to individual and their families. This in turn will improve quality of end of life and ensures that people receive care in their preferred place and die in their preferred place. In order to achieve this it is imperative that we have a suitably skilled and competent workforce delivering high quality care supported through a comprehensive end of life care education programme.

There have been some positive developments over recent years in Hull with statutory and voluntary agencies committed to working together to provide these services.

Resources

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

NHS Digital. Quality and Outcomes Framework. https://qof.digital.nhs.uk/

Updates

This page was last updated / checked on 4 March 2026.

This page is due to be updated / checked in November 2026.