RT Journal Article
SR Electronic
T1 Hospice at Home services in England: a national survey
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP 454
OP 460
DO 10.1136/bmjspcare-2019-001818
VO 11
IS 4
A1 Melanie Rees-Roberts
A1 Peter Williams
A1 Ferhana Hashem
A1 Charlotte Brigden
A1 Kay Greene
A1 Heather Gage
A1 Mary Goodwin
A1 Graham Silsbury
A1 Bee Wee
A1 Stephen Barclay
A1 Patricia M Wilson
A1 Claire Butler
YR 2021
UL http://spcare.bmj.com/content/11/4/454.abstract
AB Objective Hospice at Home (HAH) services aim to enable patients to be cared for and die at home, if that is their choice and achieve a ‘good death’. A national survey, in 2017, aimed to describe and compare the features of HAH services and understand key enablers to service provision.Methods Service managers of adult HAH services in the ‘Hospice UK’ and National Association for Hospice at Home directories within England were invited to participate. Information on service configuration, referral, staffing, finance, care provision and enablers to service provision were collected by telephone interview.Results Of 128 services invited, 70 (54.7%) provided data. Great diversity was found. Most services operated in mixed urban/rural (74.3%) and mixed deprivation (77.1%) areas and provided hands-on care (97.1%), symptom assessment and management (91.4%), psychosocial support (94.3%) and respite care (74.3%). Rapid response (within 4 hours) was available in 65.7%; hands-on care 24 hours a day in 52.2%. Charity donations were the main source of funding for 71.2%. Key enablers for service provision included working with local services (eg, district nursing, general practitioner services), integrated health records, funding and anticipatory care planning. Access to timely medication and equipment was critical.Conclusion There is considerable variation in HAH services in England. Due to this variation it was not possible to categorise services into delivery types. Services work to supplement local care using a flexible approach benefitting from integration and funding. Further work defining service features related to patient and/or carer outcomes would support future service development.All quantitative data relevant to the study are included in the article or uploaded as supplementary information. Qualitative fields note are available subject to request.