A postcode lottery exists in whether patients approaching the end of their life are able to die in hospital or at home, a major piece of research shows.

The 2008 national end of life care strategy said high quality end of life care should be available for patients whether they chose to die in hospital, in their own home or in another setting.

However, the first report from the National End of Life Care Intelligence Network - set up in May as part of the strategy - reveals that geographically across England there are significant differences in the settings where people die.

In London the lowest proportion of people die at home - 18 per cent from 2005-07. That compares with 21 per cent in the North East and 20 per cent in both the South West and the East of England.

Edwin Pugh, until recently NHS North East clinical lead for end of life care, said the strategic health authority had made rapid round the clock access to an appropriately qualified nurse its top priority for end of life care.

Professor Pugh said: “Every commissioner knows that 24/7 [access to nursing care] is the top priority, and it’s not for negotiation.”

At a local council area level, Waltham Forest and Redbridge - both in east London - had the highest proportion of patients dying in hospital, while South Cambridgeshire had the highest proportion dying at home.

A spokesman for NHS Waltham Forest said: “It’s a simple fact that people in more deprived areas are more likely to die in hospital.”

But he said the primary care trust was now prioritising offering choice in end of life care. He also said the Margaret Centre, which provides hospice-style palliative care services at Whipps Cross Hospital, affected the figure for hospital deaths.

The network’s report, which brings together for the first time national data on where people die, at what age and from what cause, also shows that patients with respiratory and cardiovascular diseases are significantly more likely to die in hospital than at home, compared with patients who have cancer.

Network director Claire Henry said: “Some of the factors contributing to relatively high rates of deaths in hospitals are beyond the immediate control of commissioners and providers. Others are not. This research must be used to shape services that ensure more people die in the setting they choose.”

She said more research would be published in the autumn.