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Sign in or register for an accountPeople have a right to be involved in discussions and make informed decisions about their care up to and including the end of their life. For many people, dying at home is seen as a preferable choice where they feel safe and comfortable. Therefore, trends and variations in place of death are used as a proxy indicator for the quality of end-of-life care. However, this is heavily caveated with the fact that people and their families need adequate care such as pain relief, symptom management, emotional and practical support to die with dignity in their own home.
Between the years 2014 and 2018 roughly one in four Salford residents died in their own home. This equated to 550 people a year. Since 2018 there has been a large increase in the number of people dying in their own home to more than 750 whilst the proportion has increased, to a lesser extent, to around 30%. The proportion of people dying at home in Salford peaked in 2021 at 32.5% before falling in consecutive years. The increase in the number of people dying at home was driven by deaths from cancer and the circulatory system which saw increases between 30% and 40%.
The increase in deaths at home coincided with the Covid-19 pandemic which may have restricted access to healthcare facilities for both patients and their families, limiting their options for their place of death. Between 2019 and 2022 Salford had a significantly higher proportion of people dying at home than both England and Greater Manchester. The most recent data, 2023, showed a similar proportion of deaths at home for Salford, England and Greater Manchester.
Salford has generally had a significantly higher proportion of deaths at home for persons of all ages than England and Greater Manchester.
[Download the dying at home data, csv format, 1kb]
It is widely acknowledged that there are inequalities in access to end-of-life care services and quality of care. Particular groups, relevant to Salford, that have been identified as having a poor experience of end of palliative care are people from black and minority ethnic communities, deprived communities, religious groups, LGBTQ+ and disease groups such as people with dementia or learning disabilities. Unfortunately, death registers do not currently collect data on many of the characteristics that would allow for local analysis on whether Salford is underperforming with respect to these communities.
Local analysis of disease groups which had more than 100 deaths at home between 2014 and 2023 showed that people dying from mental and behavioural disorders (10.6%) were significantly less likely to die at home than the Salford average (27.4%). Other disease groups where people were less likely to die at home were diseases of the respiratory system, digestive system, and nervous system. People dying from cancer were the most likely to die at home (37.8%). A substantial amount (5%) of people dying at home died as a result of external causes such as accidents, self-harm and assaults. These deaths, by definition, are unplanned and so cannot be deemed to be an indication of palliative care.
With respect to deprived communities’ analysis from the period 2014 to 2023 showed that there was no strong correlation between the deprivation score of a person’s usual address and whether they died at home. However, it is perhaps noteworthy that it appears there is wider variation between the small areas when deprivation increases.
Analysis of the local primary care mortality database (PCMD) shows that the percentage of people dying in their own homes is lowest in areas of Kersal and Broughton. This is perhaps significant because there are a high concentration of Jewish people living in those areas. People from religious groups have already been identified as experiencing worse outcomes. However, it is important to note that the data will be affected by the number of residential and nursing homes in the area. People dying in these establishments are not deemed dying at home regardless of how long they have lived there. Therefore, a high concentration in a particular area will, in all likelihood, reduce the percentage of deaths at home.
Broughton and Kersal were the areas of Salford with the lowest proportion of deaths at home in the period 2014 to 2023 combined
[Download the dying at home map data, csv format, 3kb]
Unpublished NHS data shows there were 1,452 registered patients in Salford receiving palliative care as of June 2025. This accounted for 0.4% of the total registered population. In comparison, the overall rate for Greater Manchester was higher at 0.5%, indicating that Salford had a significantly lower proportion of its population receiving palliative care.
Six local authorities within Greater Manchester reported significantly higher proportions than Salford, with Tameside recording the highest at 0.8%. Conversely, both Trafford and Manchester had significantly lower rates, each at 0.4%.
Within Salford the majority of patients receiving palliative care were within Broughton, and Eccles and Irlam Primary Care Networks (PCN). 0.9% of patients registered in Broughton were receiving palliative care. This Primary Care Network does include Care Homes Medical Practice which manages the care of all care home residents in Salford and therefore high rates of palliative care are to be expected. Salford South East PCN had the lowest proportion of its registered population receiving palliative care at 0.2%. This PCN had the lowest proportion of patients aged 75 and over which may explain low rates of palliative care.
An analysis of palliative care provision in Salford found no evidence of ethnic disparities. Among the 65+ age group, where ethnicity was recorded, 94% of registered patients identified as White. Similarly, 94.1% of individuals receiving palliative care were White, with other ethnic groups represented proportionally in line with their presence in the 65+ population.
While this comparison provides a useful indication, it is not without limitations. The analysis is based on broad age categories, and the 65+ population—used as the comparator group—accounts for approximately 75% of those receiving palliative care. However, it is important to note that Salford’s population under the age of 65 is significantly more ethnically diverse. As such, there remains a possibility that some inequalities in access may exist, particularly among younger cohorts. Nevertheless, the 65+ age group was selected as a benchmark because, at the time of writing, the data was only available in broad age groups.
In terms of deprivation things also appeared equitable. Only the least deprived quintile showed any significant difference from the Salford average. 0.35% of the least deprived quintile’s registered population were receiving palliative care, significantly lower than the Salford average of 0.45%. This is perhaps noteworthy due to the fact that the population within the least deprived quintile will be significantly older than average. However, this may have been offset by the locations of care homes and hospices in Salford being in more deprived areas of the city.
It is important to note that none of the figures above adjust for variations in population age structures within Salford and across the Greater Manchester Combined Authority, which may influence the observed differences.
The percentage of deaths that occur at home is a nuanced topic. Whilst the aim would, theoretically, be to increase the proportion of people dying at home as an indication of improved palliative care there are many caveats to that. For a start there must be adequate care both medically and emotionally for people to receive the required level of care. Secondly, for deaths at home to be an indication of improved palliative care the deaths must be planned rather than sudden.
Commissioners should enhance their capacity to evaluate and ensure the quality of end-of-life care provided at home. This includes gathering better insights into individuals' experiences from a diverse group of residents. Additionally, they need to use data more effectively to understand current and future needs, while addressing inequalities; beyond recognising their existence. Any improvements need to be co-produced with individuals and carers with experience of palliative care.
End of life care needs to be co-ordinated and readily available to everyone. This will involve increasing awareness and encouraging people to have confident conversations about living and dying well and to support each other in emotional and practical ways.