Early Identification of Patients with Palliative Care Needs
Research type
Research Study
Full title
Early identification of patients with palliative care needs in the acute hospital setting - Evaluation of a digital mortality-prediction tool and clinician training needs
IRAS ID
324092
Contact name
Timothy Jackson
Contact email
Sponsor organisation
Northern Care Alliance NHS Foundation Trust
Duration of Study in the UK
1 years, 3 months, 31 days
Research summary
Patients with life-limiting illnesses and palliative care needs are often identified late in the course of their disease, with limited opportunities remaining to plan care towards the end of their lives in the way they would wish.
This project includes quantitative and qualitative evaluation of an innovative tool (the Hospital One-year Mortality Risk, "HOMR Now!") which flags patients after admission to hospital who are most at risk of death in the following year. The tool gives a risk score, with the aim that patients exceeding a chosen score would be flagged to clinicians for consideration of referral to palliative care services and/or support with future planning etc. if the clinician feels this is appropriate. Whilst the tool has been validated in Canada, we are unaware of any similar tool in use in a UK hospital setting and this could significantly change practice within hospital-based palliative care.
The quantitative element of this project will calculate the HOMR Now! score for a cohort of patients previously admitted to hospital, with follow-up at one year to evaluate accuracy of the score. Baseline data will be collected on whether these patients were referred to palliative care or had advance care planning. The software developed to apply the HOMR Now! algorithm will not be used for a medical purpose in this study but solely to address the principal research question. There will be no change to clinical management for these patients, however the study may lead on to a future separate research proposal examining prospective use of the HOMR Now! tool.
Qualitative evaluation will comprise focus groups with clinicians, patients and carers/family. These will gather in-depth, rich data to help evaluate the acceptability of using such a clinical tool. A training needs analysis will also examine staff learning needs required to support any potential future implementation study.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
25/LO/0622
Date of REC Opinion
10 Nov 2025
REC opinion
Further Information Favourable Opinion