Terminally ill people and their families are being let down by failings in end of life care, a watchdog says.
The National Audit Office said while most people wanted to die at home, the majority ended their days in hospital.
The report said families, hospices and care homes in England needed more help to provide better end of life services.
And the watchdog cast doubt on the government's plans to improve care. Ministers insist that an improvement plan for care is "right on track".
About 500,000 people a year die in England, mostly following a period of chronic illness such as heart disease, cancer or dementia.
About a third happen at home or in a care home, while 58% die in hospital.
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The report, compiled through surveys of patients, doctors, nurses and NHS trusts, said there was a lack of support to help keep people at home or in care homes leading to "unplanned and unwanted" admissions to hospital during the final days of life.
It pointed out front-line staff lacked basic training with only 29% of doctors and 18% of nurses receiving training in end of life care. Meanwhile, there is no formal training for care home staff.
The watchdog said hospices offered a valuable alternative to hospital, but struggled through lack of funding and support from the NHS and local authorities.
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