Background A collaborative project between the clinical and research teams at a hospice in Scotland highlights a person-centred model of Hospice at Home being developed and utilised with a focus on ‘what matters to patients and families’.

Aims

• Evaluate the impact and potential benefit of Hospice at Home and identify the factors that underpin these.

• Support the development of a model of care that underpins the Hospice at Home service.

Methods The evaluation part of the project was informed by a pluralist approach, allowing for evaluating the complexity of a service by taking into account its organisational context. The pluralist model encourages participation of stakeholders and takes account of varied data sources. Within this study this consisted of:

• Interviews and focus groups with managers and the new Hospice at Home team.

• Descriptive quantitative data.

• 15 patients’ case stories.

Results During the period of the study 140 patients were admitted to the service. The most frequent reason for the service being requested was for psychological support, the average length of stay in the service was 17.1 days with the majority of patients staying in the service for 8.0 days.

The model of care underpinning the new Hospice at Home service enabled person-centred care in patients’ homes. Three key elements of the model were identified: flexible and responsive care; relationship based care; and empowering patients and family members. The key outcomes of this model of care were identified as family members feeling supported and patients being able to be cared for and die in their preferred place.

Conclusion The person-centred care model of the Hospice at Home service enabled a level and focus of care that adds a new layer to care within the community. This person-centred model of care may be meeting the needs of patients with less clinical/medical palliative care needs and be more appropriate than the more traditional medical model.