Barclay, Stephen

Brigden, Charlotte L.

Butler, Claire

Gage, Heather

Greene, Kay

Hashem, Ferhana

Hayes, Cathy

Mikelyte, Rasa

Rees-Roberts, Melanie

Wee, B

Williams, Peter

Wilson, Patricia M.

Kent Academic Repository

Kent Academic RepositoryFull text document (pdf)Copyright & reuseContent in the Kent Academic Repository is made available for research purposes. Unless otherwise stated allcontent is protected by copyright and in the absence of an open licence (eg Creative Commons), permissions for further reuse of content should be sought from the publisher, author or other copyright holder. Versions of researchThe version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record.EnquiriesFor any further enquiries regarding the licence status of this document, please contact: researchsupport@kent.ac.ukIf you believe this document infringes copyright then please contact the KAR admin team with the take-down information provided at http://kar.kent.ac.uk/contact.htmlCitation for published versionRees-Roberts, Melanie and Mikelyte, Rasa and Hayes, Cathy and Hashem, Ferhana and Brigden,Charlotte L. and Gage, Heather and Williams, Peter and Greene, Kay and Wee, B and Barclay,Stephen and Wilson, Patricia M. and Butler, Claire  (2017) Optimum Hospice at Home Servicesfor End of Life Care (OPEL H@H): Results of survey data from hospice at home services in England.DOILink to record in KARhttps://kar.kent.ac.uk/70496/Document VersionPublisher pdfINSIDE THE HOUSETable 2. Number of Annual Referrals per Staff Figure 4. Types of Service FundingOptimum Hospice at Home Services for End of Life Care (OPEL H@H): Results of survey data from hospice at home services in EnglandWhy are we doing this study?Hospice at Home (H@H) services provide patients with choice about where they receive their care at the end of life, which is central to UK policy [1]. The number of people expressing a wish to die at home is increasing [2-4]. At present health and social care services are ill equipped to meet this demand [5]. There is wide variation across the country in H@H service provision. Services that have been evaluated often demonstrate positive beneÞts for patients [6-8]. It is unclear what elements of these services deliver which outcomes and what role other primary care and community services play. This project has produced a comprehensive map of the range and variation of H@H services in England.Rees-Roberts M, Mikelyte R,  Hayes C,  Hashem F, Brigden C, Gage H, Williams P, Greene K, Wee B, Barclay S, Wilson P, Butler CMethods                                                                                                                       A national telephone survey of                                                                                             H@H adult services listed in the ÔHospice                                                                                     UKÕ and National Association for Hospice at Home                                                                              directories within England was conducted.                                                                 128 H@H services were approached via post to take                                                         part in the survey. Survey telephone calls were conducted                                                by an experienced palliative care nurse who was able to                                       understand details of service conÞguration and operation.                                 Services were contacted a maximum of three times to arrange a telephone                  survey. Between February 2017 and June 2017:   ¥ 70 surveys completed   ¥ 22 H@H services opted out   ¥ 36 non-respondersAnalysis: The interpretation of the survey Þndings involved statistical analysis combined with iterative consensus work with the project team including Patient and Public Involvement. H@H services: ¥ did not fall into clear categories according to type¥ are very different across England¥ cover mixed populations across diverse areas¥ utilise a wide range of staff types ¥ provide a wide range of care and provide these 24/7¥ can respond rapidly to patients¥ care for patients with a wide range of life expectancies (hrs/days to >12 months)¥ only 25% of services receive NHS funding, only 4% are fully NHS funded¥ operate to Þll gaps in other local healthcare servicesOnly 3 / 70 H@H services were fully funded by the NHS                        We will be choosing case study sites for further in-depth data collection. The aim is to investigate the impact of the delivery of different models of H@H on patient & carer outcomes and  experiences of end of life care. Our  focus is on: What are the features of H@H models that work, for whom and      under what                        circumstances?          Next StepsThis research was funded by the NIHR Health Services and Delivery Programme (project number 14/197/44)         The views expressed are those of the author(s) and not             necessarily those of the NHS, the NIHR or the DOH.Table 1. Size & Setting of H@H ServicesTable 3. Availability & Range of Care ProvidedFigure 1. Number of Hospices with dedicated H@H staff disciplinesFigure 2. Ratio of Care-Providing StaffMap ofHospices Surveyed 1. Department of Health. End of Life Care Strategy Ð promoting high quality care for all adults at the end of life.       2008 London: HMSO.2. Sheppherd S, Wee B, Straus SE. Hospital at home: home-based end of life care (Cochrane Review) 2012, www.thecochranelibrary.com3. Gomes B, Calanzani N, Gysels M, Hall S Higginson IJ Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliative Care 2013, 12:74. Higginson IJ, Sarmento VP, Calanzani N, Benalia H and Gomes B. Dying at home - is it better: A narrative appraisal of the state of the science, Palliative Medicine 2013 27 (10) 918-9245. Leadbeater C and Garber J. Dying for Change. London: Demos, 2010.6. Jack B, Groves K, Baldry C, Gaunt K, Sephton J, Whelan A, Whomersley S. Evaluation of the Queens court at Home Pilot Service: Executive Summary. March 2010 www.edgehill.ac.uk/eprc/Þles/2011/08/QCH_ExecutiveSummary.pdf (accessed 17/10/2014)7. Jack BA, Baldry CR, Groves KE, Whelan A, Sephton J, Gaunt K. Supporting home care for the dying: an evaluation of healthcare professionalsÕ perspectives of an individually tailored hospice at home service. Journal of Clinical Nursing. 2013 (22) 2778-2786.8. King G, Mackenzie J, Smith H and Clark D. Dying at home: evaluation of a hospice rapid response service. International Journal of Palliative Nursing, 2000, 6(6):280-287SettingFigure 3. Patient Life Expectancy - H@H Service Referral CriteriaStafÞng ReferralsCare Provision Funding Key MessagesPercentage of hospices receiving the above types of funding4 services operated an H@H service using HCAs only (with a nurse manager), 4 H@H services operated using nurses only64% of H@H services could respond to patients within 4 hours if neededn=68

Optimum Hospice at Home Services for End of Life Care (OPEL H@H): Results of survey data from hospice at home services in England

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Optimum Hospice at Home Services for End of Life Care (OPEL H@H): Results of survey data from hospice at home services in England

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