Background It is current practice for the Community Palliative Care Nurse Specialist (CPCNS) service at Wigan & Leigh Hospice (WLH) to provide all assessments in patients' own homes. While the value that patients place upon CPCNS services has been extensively explored in the literature, their views regarding the location of assessments have not been considered.
Aims To explore the value that patients who are functionally able to attend clinics, place on the location of their CPCNS assessments.
Methods Semistructured interviews of CPCNS service users assessed as functionally able to attend a clinic. The interviews were transcribed and thematically analysed. Ethical approval was obtained through The Department of Health Research Ethics Committee at Lancaster University and the research panel at WLH.
Results Home-based assessments add a distinct quality to the CPCNS assessment, positively facilitating communication, empowerment, information and advice provision as well as responsiveness and flexibility. Concerns regarding clinic environments included confidentiality, unpleasant waiting room environments, long waiting times, inflexibility and the burden of travelling. Clinics enveloping principles of ‘at-homeness’, such as friendly staff and pleasant waiting areas were perceived as more helpful than those described as more clinical.
Conclusions The cost-effectiveness of CPCNS clinics for current service users is questionable due to their perceived burden of travel and fluctuating clinical conditions, which may impact upon higher levels of appointment non-attendance. CPCNS clinics may offer an opportunity for the wider access of people for short term, multidisciplinary interventions earlier in their disease trajectory. Such clinics should envelop the principles of ‘at-homeness’, responsiveness and flexibility, that are so valued by service users. Further research is required into how CPCNS, Palliative Medicine and the wider multidisciplinary team can better integrate to continue in the quest for high quality, needs appropriate, timely and cost-effective palliative care for all who require it.
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