From the books we read and the food we eat, to the places we live and the people we spend our time with, our lives are made up of choices. And the end of our lives should be no different. Find out what Macmillan is doing to support choice at the end of life.
Why are we campaigning?
Right now, too many of us aren’t able to choose where we’d like to die because we can’t get the support we’d need to do so. With access to vital services, such as free social care, many more people would be able to spend their precious final days in a familiar place of their choosing.
With the right support, 73%* of people with cancer would prefer to die at home. But only 29% actually do.** If current trends continue, then we estimate that by 2020 more than 220,000 people with cancer will die in hospital when they wanted to die at home.***
Providing free social care to people at the end of life therefore presents an opportunity to both support more people’s choices about where and how they die while spending less money doing it. Each year the NHS spends an estimated £685 million on hospital care at end of life for all people who die in hospital, but who wanted to die at home. ****
Read our latest campaigns report [PDF].
What do we want to change?
We want anyone living with cancer, nearing the end of their lives, to be given the support they need to be able to choose where they are cared for and where they die.
In particular, Macmillan is campaigning to make sure that free social care at the end of life and the freedom to choose where you die become priorities for the government.
Our policy report, Time to Choose: Making choice at the end of life a reality [PDF], outlines the barriers to choice people face at the end of life, and sets out recommendations for ensuring more people approaching the end of life can be cared for and die in the place they want to be.
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* Statistic taken from Macmillan February 2010 online survey of 1,019 UK adults living with cancer. Seventy-three percent of people with cancer said they would prefer to die at home if all their concerns about dying at home (such as access to pain relief, round the clock care, and support for their family and carers) were addressed.
** Office for National Statistics. Mortality statistics: deaths registered in 2011 in England and Wales.
*** Macmillan estimates that, between 2015 and 2020, 305,000 people will die from cancer. National Bereavement Survey (VOICES) from 2012 showed that 73% of people with cancer died in hospital when home was their preferred place of death. We applied this proportion to the above estimate of people who will die from cancer in the period 2015-2020 to estimate that, if this proportion remains the same, 222,650 people would die in hospital when they would have preferred to die at home.
**** Statistics taken from Macmillan report ‘Can we live with how we’re dying?’. Using Hospital Episodes Statistics Data, we estimate that the average length of stay in hospital for someone at end of life is 12.9 days. The National Council of Palliative Care estimates that the proportion of end of life patients who need specialist palliative care is 45–47%. Applying this to Personal Social Services Research Unit indication that an average cost of £340 per day for inpatient specialist palliative care and National Audit Office figures which indicate generalist hospital care costs £250 per day, we estimate that the average cost for an individual’s final stay in hospital would be approximately £3,770. This is then applied to all 180,000 people who die in hospital each year who would prefer to die at home.