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Hospice at Home services in England: a national survey

Rees-Roberts, Melanie, Williams, Peter, Hashem, Ferhana, Brigden, Charlotte, Greene, Kay, Gage, Heather, Goodwin, Mary, Silsbury, Graham, Wee, Bee, Barclay, Stephen , Wilson, Patricia M and Butler, Claire (2019) Hospice at Home services in England: a national survey BMJ Supportive & Palliative Care. bmjspcare-2019.

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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 52.2%. Charity donations were the main source of funding for 71.2%. Key enablers for service provision included working with local services (eg, district nursing, general practitioner 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
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors : Rees-Roberts, Melanie, Williams, Peter, Hashem, Ferhana, Brigden, Charlotte, Greene, Kay, Gage, Heather, Goodwin, Mary, Silsbury, Graham, Wee, Bee, Barclay, Stephen, Wilson, Patricia M and Butler, Claire
Date : 28 October 2019
Funders : National Institute for Health Research Health Services and Delivery Research Programme
DOI : 10.1136/bmjspcare-2019-001818
Copyright Disclaimer : © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Depositing User : James Marshall
Date Deposited : 05 Jun 2020 15:46
Last Modified : 05 Jun 2020 15:46
URI: http://epubs.surrey.ac.uk/id/eprint/857099

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