Global palliative care response to COVID-19

16th April 2020

The relief of suffering, supporting complex decision-making and managing clinical uncertainty are key attributes of palliative care.  These are also essential components of the response to epidemics and pandemics. COVID-19 is leading to a surge in demand for healthcare services, including palliative and end of life care.  These services must respond rapidly, adopting new ways of working as resources are suddenly stretched beyond their normal bounds. 

A team of researchers and clinicians based at the Cicely Saunders Institute has published a rapid review of evidence into the role and response of palliative care and hospice services in epidemics and pandemics.  The article appears in the Journal of Pain and Symptom Management.

The team synthesised evidence on how hospital and palliative care teams can adapt rapidly in pandemic situations similar to COVID-19.  The aim of this work is to provide information of real practical use to services globally who are anticipating their resources suddenly stretched beyond normal bounds.

The team conducted a rapid systematic review according to PRISMA guidelines in five databases.  The studies included were from West Africa, Taiwan, Hong Kong, Singapore, the Unites States and Italy.   

The evidence shows that hospice and palliative services have an essential role in the response to COVID-19.  These services can respond rapidly and flexibly.  They have protocols for symptom management, and can train non-specialists in their use.  They can be involved in triage and can access community resources through existing links.  They have access to community networks and can redeploy volunteers to provide psychosocial and bereavement care.  They have skills in team support and dealing with staff stress.  They also have experience in the use of technology to communicate with patients and carers and they have data collection systems to inform operational changes and improve care.

The full article is available at

Etkind SN, Bone AE, Lovell N, Cripps RL, Harding R, Higginson IJ, Sleeman KE. The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic. Journal of Pain & Symptom Management 2020. DOI:

An evidence synthesis on the role and response of hospice and palliative care in epi/pandemics, to inform response to COVID-19. Hospice and palliative care services should: respond rapidly and flexibly; produce protocols; shift resources to the community; redeploy volunteers; facilitate staff camaraderie; communicate with patients/carers via technology; standardise data collection.