Executive summary

Across OECD countries, timely access to adequate end-of-life care to relieve symptoms for those with terminal illnesses such as pain, breathlessness, and distress, named as palliative care, is low, with less than 40% of those in need receiving care. Despite a preference to die at home, half of deaths happen in hospital, often due to lack of in-home and community-based support. Provision of palliative care to provide comfort and improve quality of life often happens at a late stage in the process because mechanisms to ensure timely access are scarce. Less than a third of the OECD countries have national programmes to monitor the time span between referral and delivery of end-of-life care services. Finally, the COVID‑19 pandemic has brought to stark prominence the reality of overwhelmed health systems which struggled to provide end-of-life care and the necessity for systems to be scalable and adaptable in the face of emergencies.