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Service evaluation of community-based palliative care and a hospice-at-home service
  1. Janet Wilson1,
  2. Julie Steers1,
  3. Kath Steele1,
  4. James Turner1,
  5. Allison Tinker2
  1. 1Department of Nursing and Midwifery, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield UK
  2. 2Rotherham Hospice, Rotherham, UK
  1. Correspondence to Janet Wilson, j.l.wilson{at}shu.ac.uk

Abstract

Background Hospices and other palliative and end-of-life care providers are required to develop services that aim to improve the quality of end-of-life care and choices for those living with or dying from a life-threatening illness. In 2010, an NHS clinical commissioning group in South Yorkshire, UK, produced a strategic plan that aimed to improve the quality and choice of end-of-life care locally.

Aims To explore the views of key stakeholders, including healthcare staff and service users, of the expanded hospice-at-home service.

Method A qualitative methodology was used to explore stakeholder views. Focus groups were conducted with four stakeholder groups: patients/carers; community nursing staff; palliative care nurse specialists; and GPs/senior managers. Data analysis used a framework approach to categorise the stakeholder responses.

Findings Participants perceived that important aspects of end-of-life care needs were being met including quick access to hospice-at-home services and the prevention of admission to hospital for patients who received visits and treatment at home from this service. Issues that needed improvement included communication between hospital and community services, education and training needs regarding the use of technology and the limitations of the current service in relation to home visits from the hospice-at-home service.

Conclusions Recommendations included 24-hour access to home visits over 7 days each week, the provision of training and education for staff in the use of technology, talking to families about advance care planning, and improved communication between and timely transfer of information from hospital to community services when patients are discharged.

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