Evaluation of an integrated palliative heart failure service

  • Research type

    Research Study

  • Full title

    Evaluation of an Integrated palliative service providing specialist care for heart failure patients with a life limiting illness

  • IRAS ID

    254017

  • Contact name

    Clare Thetford

  • Contact email

    cthetford@uclan.ac.uk

  • Sponsor organisation

    University of Central Lancashire

  • Duration of Study in the UK

    0 years, 6 months, 13 days

  • Research summary

    Research Summary:
    People who have a terminal illness other than cancer have been identified as one of several groups who experience inequality in access to palliative care (Marie Curie, 2015; National Palliative and End of Life Care Partnership, 2015). St Catherine’s Hospice, Preston, is currently piloting a palliative care service dedicated to end stage heart failure patients in the last 12 months of life. The service represents the efforts of one service provider to begin to address inequalities through the expansion of services to patient groups previously underrepresented.

    The University of Central Lancashire will conduct a study to explore the views and experiences of service users and staff of the service. This exploratory work will address the strengths and weaknesses of the pilot service, to inform future service development within and beyond St Catherine’s Hospice. It will identify and prioritise issues of greatest salience to patients and carers in the provision of palliative care within end stage heart failure, and thus will speak to recent recommendations over the development of condition-specific guidelines to support end of life care.

    Participants will include patients who use the clinic, their carers and family, and staff members delivering the clinic. Recruitment will take place via the Hospice. Participants will take part in one semi-structured interview of around one hour.During the interview they will be asked about the clinic's strengths and weaknesses, unmet needs, and potential improvements to the service. Patients and carers will be interviewed at the Hospice or in their own home, according to preference. Staff will be interviewed at the Hospice. Interviews will be audio recorded, transcribed, and qualitatively analysed using a Framework Analysis approach.

    The study will run until September 2019. Funding is provided by St Catherine's Hospice and St James' Place Charitable Foundation.

    Summary of Results:
    The aim of this qualitative evaluation was to understand the strengths and limitations of an integrated heart failure palliative pilot service provided by St Catherine’s Hospice, Preston, and to assess if the clinic was successful in meeting its aims.

    1) Appointment length was crucial to enable more time for Advance Care Planning and the inclusion of families as co-recipients of care;
    2) Integration of a specialist heart failure nurse enabled targeted palliative care;
    3) Successful coordination of follow-up and inter-agency care and ensuring Preferred Place of Death;
    4) Service referrals lower than anticipated and at more advanced stages;
    5) Wider benefits included mutual upskilling; better generalist palliative care in cardiology settings, and; awareness and dissemination within palliative and heart failure professions.

    Summary of Results:
    The aim of this qualitative evaluation was to understand the strengths and limitations of an integrated heart failure palliative pilot service provided by St Catherine’s Hospice, Preston, and to assess if the clinic was successful in meeting its aims.

    1) Appointment length was crucial to enable more time for Advance Care Planning and the inclusion of families as co-recipients of care;
    2) Integration of a specialist heart failure nurse enabled targeted palliative care;
    3) Successful coordination of follow-up and inter-agency care and ensuring Preferred Place of Death;
    4) Service referrals lower than anticipated and at more advanced stages;
    5) Wider benefits included mutual upskilling; better generalist palliative care in cardiology settings, and; awareness and dissemination within palliative and heart failure professions.

  • REC name

    North West - Preston Research Ethics Committee

  • REC reference

    19/NW/0191

  • Date of REC Opinion

    25 Apr 2019

  • REC opinion

    Further Information Favourable Opinion