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Abstract
Background Many health providers saw dynamic, responsive service change during the COVID-19 pandemic (Lewis, Pereira, Thorlby et al. Understanding and sustaining the health care service shifts accelerated by COVID-19. The Health Foundation, 2020), and hospices were no exception (Van Langen-Datta, Driscoll, Fleming, et al. Compromised connections: The impact and implications of Covid-19 on hospice care in the West Midlands and nationally. Marie Curie, 2022). The introduction of integrated care systems (ICSs) encourages system partners to work collaboratively and therefore it’s important to reflect on hospice service provision in relationship to the local palliative care health economy.
Aim To use local and national tools to inform a hospice’s strategic review, including hospice clinical services, population demographics, projections and qualitative evidence to redefine the hospice provision of care and strategic direction.
Method Local tools
Hospice strategic needs analysis (SNA).
ICS palliative and end of life care strategic needs analysis.
Patient and carer evaluation.
System partner consultation.
National tools
Ambitions framework (National Palliative and End of Life Care Partnership, 2021)
NHS England and Improvement (NHSEI) model of Universal Palliative and End of Life Care which builds on the NHSEI Comprehensive Model for Personalised Care.
Results Hospice SNA Hospice – clinical services performance data.
ICS SNA – ICS data and projections showing an aging multi-morbid population, rising dementia, frailty and projected increase in deaths.
Patient and carer evaluation – Community’s view of our services and their needs.
System partners consultation – ICS end of life board and network, primary care networks, community and acute trust exploration of needs and expectation of services.
The national Ambitions Framework – Hospice review using the six dimensions identifying gaps and areas to improve.
NHSEI universal model – Visualisation of our generalist, targeted and specialist offer for inpatient, living well, community, family support and education, demonstrating complexity of services.
Conclusion These local and national tools provided breadth to the strategic review allowing celebration of successes, identification of gaps and areas for improvement. The national tools more importantly opened up helpful strategic discussions based on our provision of care within the ICS, ideas for collaboration and development of our strategic priorities.