Centre for Health Services Studies

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What are the features of Hospice at Home models that work, for whom, and under what circumstances?

Offering a choice about where people receive care at the end of life is central to UK policy and the numbers of people wishing to die at home is increasing. There are a range of “Hospice at Home” (HAH) services and most operate within non NHS settings, but are funded to provide NHS specialist care. Gaps exist in the evidence around what works best in terms of outcomes.

This three year project, funded by the NIHR Health Services and Delivery Research Programme is a collaboration between CHSS, Pilgrims Hospices East Kent, and the Universities of Cambridge and Surrey. The team will conduct a realist evaluation of a range of UK ‘Hospice at Home’ service models to understand their impact on patients and carers, and identify which features work for whom, under what circumstances. A project PPI (patient and public involvement) advisory group will advise on sensitive approaches to working with bereaved people. The project team includes two lay members.

The project incorporates three phases.
Phase 1: A national telephone survey of all HAH services in the UK on funding, staffing levels and roles, extent of service and care, local demographics etc. Data will inform the design of a typology of services, patterns and models using a CMOc framework (Context-Mechanism-Outcome configuration). 1-2 case studies per service model will receive in-depth investigation.
Phase 2: An economic evaluation to compare the costs of delivering services in the different models and assess which models are likely to lead to the best outcomes and represent best value for money.
Phase 3: Stakeholder validation
Two national workshops will gather feedback on the implications of data findings from HAH providers, local health service planners and service user representatives. Guidelines will be developed to help plan HAH services in the future. Dissemination strategy includes a project report, conference presentations and peer reviewed journal articles aimed at professional audiences.

Start date: 01/02/17 End date: 31/01/20
Funder: NIHR Health Services and Delivery Research programme. 14/197/44 HS&DR Researcher-led
Funding: £760,162
Project team:
CI: Dr Claire Butler
Contractor: University of Kent
Co-investigators:
CHSS, Uni of Kent: Prof Tricia Wilson, Dr Ferhana Hasham,
University of Cambridge: Dr Stephen Barclay
University of Surrey: Prof Heather Gage, Dr Peter Williams
Pilgrims Hospices East Kent: Ms Charlotte Brigden
NHS England: Prof Bee Wee, (Nat Clin Dir. End of Life Care/Assoc Prof Uni of Oxford)
Nat Assn for Hospice at Home (NAHH): Ms Kay Greene, Chair & Trustee
PPI/Service users: Ms Nicola Enright, Mr Graham Silsbury


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Last Updated: 25/09/2017