Background It is a ‘wicked problem’ that the gold standards of care created within the hospice setting are not always effectively influencing national, regional or local policy. This struggle is something which the public health sector has successfully contended with. In particular an approach known as Health in All Policies (HiAP) has been developed to lay down the rules of engagement and guide the exchange between organisations from all sectors. This synergy allows for an exploration of the possibilities of utilising HiAP within end-of-life care. In particular, this study will look at how the HiAP can be adapted to better integrate end-of-life care throughout the population.

Objectives

1. To investigate HiAP as an intervention

2. To develop a framework for implementing a HiAP approach to end-of-life care

3. To evaluate the possible impacts of changing the manner in which end-of-life care integrates within England.

Systematic review The utilisation of HiAP in healthcare and specifically in end-of-life care.

Ethnographic study A study of the stakeholders within end-of-life care which will aim to understand the problem surrounding influence and policy translation in end-of-life care.

Action research HiAP will be unpicked into a framework which is transposable to end-of-life care. Utilising this, a study will be designed to analyse its applicability to end-of-life care and the possibilities moving forward.

Relevance Increasing death rates, more complex co-morbidities and evidence of unmet need, signals a future where the demand for end-of-life care will increase. Hospice care can be exceptional but will only touch a fraction of those who will die. We need to be able to effectively share what we know with others, now more than ever before, to support tomorrow’s patients.