Understanding and improving out-of-hours community palliative care

• Research type

  Research Study

• Full title

  Phase 2 and 3: Understanding and improving community-based palliative care outside of normal working hours

• IRAS ID

  271647

• Contact name

  Richard Harding

• Contact email

  richard.harding@kcl.ac.uk

• Sponsor organisation

  King's College London

• Duration of Study in the UK

  2 years, 1 months, 31 days

• Research summary

  Background:
  Provision of community specialist palliative care (SPC) outside of normal working hours (‘out-of-hours’) in the UK is highly variable and inequitable. Service components across the country differ markedly and discontinuity of community-based care is common. Without adequate ‘out-of-hours’ support, patients are at risk of being ‘crisis-managed’ with emergency department (ED) attendances and unplanned admissions. The lack of a consistent method to delineate models of ‘out-of-hours’ care is leading to; poor quality evaluations of services, uncertainty over effectiveness/cost-effectiveness of community-based models of palliative and end-of-life care, and inability to advance the state of the science about these.

  Aim: To understand different models of ‘out-of-hours’ community based specialist palliative care (SPC), develop a typology for these models, and compare the experience of patients and families from differing models of ‘out-of-hours’ care.

  Phases/ Objectives:
  Phase 1:
  Objective 1. Systematically review the evidence for models of out-of-hours care for patients and families receiving community based SPC and develop a logic model.
  Phase 2A
  Objective 2. Establish patient, family and health care professionals’ opinions on the components required for effective and integrated ‘out-of-hours’ community based SPC
  Phase 2B:
  Objective 3. Seek expert opinions (Patient and Public involvement members, specialist palliative care and generalists) to rank, refine and reach consensus on service components that are important for providing high quality out-of-hours community based SPC
  Phase 2C:
  Objective 4. Understand models of out-of-hours care across the UK using the refined service components
  Objective 5. Develop a typology for models of out-of-hours community based SPC.
  Phase 3:
  6. Explore and contrast patients’ and families’ experiences of different models of ‘out-of-hours’ community based palliative care and understand their perspectives on drivers of service utilisation (ED attendances and unplanned admissions) and preferred place of care

  Methods: Mixed methods study; systematic review, focus groups, Delphi study, in depth interview study.

• REC name

  London - Bloomsbury Research Ethics Committee

• REC reference

  19/LO/1865

• Date of REC Opinion

  8 Jan 2020

• REC opinion

  Further Information Favourable Opinion