Many people who say they want to die at home die in hospital

Marie Curie Cancer Care says a pilot scheme carried out in Lincolnshire, in which people were offered the choice, saw home deaths increase dramatically.

The charity also says the cost of care went down as a result.

The government's cancer tsar hailed the scheme, and said he hoped key features would be incorporated into a new end of life strategy currently being drawn up.

While everyone can ask to die at home, resources do not always permit this. An estimated 64% of patients want to, but in reality only 25% do so.

Four percent want to die in hospital, but in fact 47% do so, the charity says.

We know that many older people are unnecessarily rushed into hospital at the end of their lives because care staff or relatives feel unsure about how to act in their best interest Gordon Lishman Age Concern

But the Marie Curie Delivering Choice Programme, piloted in Boston, more than doubled the number of patients dying at home - from 17% to 42%, over two years.

"I would like Delivering Choice to be taken up by every healthcare authority for them to learn from the extraordinary story of Lincolnshire," said Thomas Hughes-Hallett, chief executive of Marie Curie Cancer Care.

'Pioneering'

The scheme would not be for everyone: people who want to die at home must have a relative or friend who is prepared to look after them, and their home would be checked to see if it was suitable.

Iris built up a good rapport with the team who, in turn, helped us to support her and access a good quality of life at home Daughter Glenis

The project provides nurses who liaise between hospital and patient, and a "rapid response team" who come out to the home in an emergency.

This team, who come in place of an ambulance crew, reduce the likelihood of the patient going back into hospital from where, experience shows, they are unlikely to return, the charity said.

Marie Curie claims the total cost of end of life care for the area went down by 8% as a result of the programme.

But while the charity is funding several other programmes across the country, it says it cannot afford to back a nationwide scheme.

It estimates it would cost the NHS �17m over seven years to start offering the service to every terminally ill patient.

The government's National Cancer Director, Professor Mike Richards, said: "They're right to be excited".

He went on: "I've been watching this since it started and they've done extremely well, particularly in coordinating services and the rapid response teams."

Charities Help the Aged and Age Concern also gave the project a warm welcome.

"We know that many older people are unnecessarily rushed into hospital at the end of their lives because care staff or relatives feel unsure about how to act in their best interest," said Age Concern chief executive Gordon Lishman.

Paul Cann of Help the Aged described it as a "pioneering initiative".

"What's most impressive is that actual location of death is increasingly shifting from hospitals and care homes to people's own homes, providing greater dignity and choice."