Community out-of-hours palliative care – ‘a patchwork of services’

3rd February 2025

People receiving palliative care at home need support from different services, including care outside normal working hours. However, the availability and quality of this care vary, and it’s unclear which approaches work best.

This study explored different models of out-of-hours palliative care in the UK by interviewing 39 healthcare professionals from different areas. Researchers identified four main models based on how well services work together, the balance between generalist and specialist care, and the type of care provided.

Key challenges included coordinating multiple services, managing distressing symptoms quickly, and dealing with limited resources. To improve care, the researchers suggested having a single contact point for patients, better integration of services, and ensuring fast, skilled symptom management. The study offers recommendations for a better care model based on these findings:

“The model of care that most strongly facilitates high quality care is highly integrated and comprises of: a single point of access, staffed by experienced palliative care healthcare professionals, with access to shared electronic patient records and is positioned and skilled to coordinate care across all involved services. Out-of-hours care is ‘never only one service’, detailed coordination and formal structures and processes are required to ensure effective and efficient integration and achieve high-quality care”.

Firth AM, Goodrich J, Gaczkowska I, Harding R, Murtagh FE, Evans CJ. Community out-of-hours palliative care – ‘It’s a patchwork of services’: A qualitative study exploring care provision. Palliat Med. 2025 Feb;39(2):245-255. doi: 10.1177/02692163241302671. Epub 2024 Dec 11. PMID: 39660405; PMCID: PMC11776347.