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Hospice at Home services in England: a national survey

Rees-Roberts, Melanie, Williams, Peter, Hashem, Ferhana, Brigden, Charlotte L., Greene, Kay, Gage, Heather, Goodwin, Mary, Silsbury, Graham, Wee, Bee, Barclay, Stephen, and others. (2019) Hospice at Home services in England: a national survey. BMJ Supportive and Palliative Care, . pp. 1-7. ISSN 2045-435X. (doi:10.1136/bmjspcare-2019-001818) (KAR id:78220)

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Abstract

OBJECTIVE: Hospice at home (HAH) services aim to enable patients to be cared for and die at home, if that is their choice and achieve a “good death”. A national survey, in 2017, aimed to describe and compare the features of HAH services and understand key enablers to service provision. METHODS: Service managers of adult HAH services in the ‘Hospice UK’ and National Association for Hospice at Home directories within England were invited to participate. Information on service configuration, referral, staffing, finance, care provision and enablers to service provision were collected by telephone interview. RESULTS: Of 128 services invited, 70 (54.7%) provided data. Great diversity was found. Most services operated in mixed urban/rural (74.3%) and mixed deprivation (77.1%) areas and provided hands-on care (97.1%), symptom assessment and management (91.4%), psychosocial support (94.3%) and respite care (74.3%). Rapid response (within 4 hours) was available in 65.7%; hands-on care 24 hours a day in 52.5%. Charity donations were the main source of funding for 71.2%. Key enablers for service provision included working with local services (e.g. district nursing, GP services), integrated health records, funding and anticipatory care planning. Access to timely medication and equipment was critical. CONCLUSION: There is considerable variation in HAH services in England. Due to this variation it was not possible to categorise services into delivery types. Services work to supplement local care using a flexible approach benefitting from integration and funding. Further work defining service features related to patient and/or carer outcomes would support future service development.

Item Type: Article
DOI/Identification number: 10.1136/bmjspcare-2019-001818
Uncontrolled keywords: End of life, hospice at home, palliative care, services, hospice
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Meg Dampier
Date Deposited: 04 Nov 2019 12:57 UTC
Last Modified: 18 Nov 2020 16:06 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/78220 (The current URI for this page, for reference purposes)
Rees-Roberts, Melanie: https://orcid.org/0000-0002-7121-0414
Hashem, Ferhana: https://orcid.org/0000-0002-2544-1350
Wilson, Patricia M.: https://orcid.org/0000-0002-5787-9736
Butler, Claire: https://orcid.org/0000-0001-9501-2861
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