More than 100,000 extra deaths in private homes in UK since pandemic began

More than 100,000 extra deaths have taken place in private homes in the UK since the Covid-19 pandemic began, new analysis shows.

Extra deaths, known as excess deaths, are the number of deaths that are above the average recorded in previous years.

But although Covid-19 has been one of the main drivers of excess deaths in hospitals and care homes, the virus has accounted for only a minority of the extra deaths in homes.

The analysis has been compiled by the PA news agency with Hospice UK, based on data from the UK’s statistics agencies.

It shows that 87,196 excess deaths in private homes have been registered in England and Wales since the start of the pandemic, while 11,113 have been registered in Scotland.

The latest available figures for Northern Ireland show 2,620 excess deaths took place in private homes from March 2020 to December 2021.

This adds up to a UK-wide figure of 100,929 – though because data for Northern Ireland from January 2022 onwards has yet to be published, the most recent total is certain to be higher.

Dominic Carter, head of policy and research at Hospice UK, said it was “incredibly concerning” that the subject of deaths at home had not been included in the draft terms of reference published on Thursday for the Government’s Covid-19 public inquiry.

He added: “Without closer investigation into what happened to people dying at home we won’t know what they experienced, and thousands more could still miss out on the expert care they deserve.”

Deaths in private homes have been consistently above average since the early weeks of the pandemic, even during periods when lockdown restrictions were eased in various parts of the country.

At the peak of the second wave of the virus in early 2021, when the UK was in full lockdown, excess deaths in homes in England and Wales numbered about 1,200 to 1,300 a week – but during summer 2021, when comparatively few rules were in place, deaths still numbered between 700 and 900 a week.

Since the start of 2022 the figure has been between 400 and 600.

Scotland has seen excess deaths in home average just above 100 for much of the pandemic, though the figure has dropped below 100 since the beginning of this year.

The lower totals so far in 2022 might have been affected by a change in the way excess deaths are compiled by the UK’s statistics agencies.

In England and Wales, the Office for National Statistics (ONS) calculated figures for both 2020 and 2021 by comparing deaths with the average for the equivalent week in the pre-pandemic period of 2015 to 2019.

For 2022 it has switched to using an average based on 2016-2019 plus the pandemic year of 2021, to better reflect population changes since the outbreak began, but avoiding the high levels of mortality in 2020.

The National Records of Scotland (NRS) has followed a similar approach, while the Northern Ireland Statistics and Research Agency (NISRA) used 2015-19 for excess deaths in 2020 and 2016-20 for excess deaths in 2021.

“The pandemic has seen a vast increase in the number of people dying at home, leaving health and social care professionals finding it hard to meet the needs of patients as quickly or fully as they would like,” Dominic Carter of Hospice UK said.

“Vital lessons need to be learned to uncover crucial information needed by Government, local systems and the health and care workforce to better support people at the end of life now.

“We estimate that between March 2020 and December 2021, at least 67,000 people who died at home did not get all the support they needed, with care often falling on the shoulders of the loved ones around them.”

Responding to the figures, Dr Laura Chapman, medical director at the Marie Curie Hospice in Liverpool, said: “This analysis backs up what family carers have been telling us since the first lockdown. The majority of carers told us that their loved one had unmanaged symptoms and struggled alone during evenings and weekends without support at home before they died.

“As time passes, we’re beginning to see the extent of the hidden crisis that families are facing behind closed doors. The Government must recognise this isn’t solely a pandemic issue. Covid-19 has merely accelerated the number of people dying at home.

“Lessons must be learnt from the last two years to ensure we avoid generations of people in future dying unsupported and in pain, and to avoid a nation perpetually in the thrust of a traumatic grief pandemic.”

Only 12% of excess deaths in private homes in England and Wales since the start of the pandemic were deaths that involved Covid-19.

In Northern Ireland the figure also stands at 12%, while for Scotland it is even lower, at 9%.

Analysis published last year by the ONS found that “substantial increases” in people dying from causes such as heart disease, cancer, and dementia and Alzheimer’s had driven the large number of excess deaths in private homes in England and Wales between January 2020 and June 2021.

Ischaemic heart disease was the main leading cause, with deaths among males 18% above the pre-pandemic average and 10% above average for females.

Deaths where dementia and Alzheimer’s disease was the leading cause during this period were 72% above average for males and 62% above average for females – the largest percentage increase among causes.

Deaths where lung cancer was the leading cause of death were also above average, by 21% for males and 35% for females.

Commenting on these figures, Sarah Caul, ONS head of mortality analysis, said the pandemic appeared to have had “an indirect effect” on private-home deaths.

“This could be because of a combination of factors which may include health service disruption, people choosing to stay away from healthcare settings or terminally ill people staying at home rather than being admitted to other settings for end-of-life care,” she said.