The impact of COVID-19: differences between publicly managed services and hospices
25th April 2022
CovPall is a multicentre, multinational observational study of specialist palliative care during the Covid-19 pandemic. Latest published research from the study highlights differences between the busy-ness of different palliative services, and its impact on patient care.
In this large survey of hospice and palliative care services across the United Kingdom, just under half of services reported being slightly or a lot more busy during the early months of the Covid-19 pandemic, while one in three services reported being slightly or much less busy. Being busier was associated with services that provided hands-on care at home and in the community and home care services, those that were publicly (rather than charitably) managed, those that had experienced more confirmed cases of Covid-19, and those that had experienced staff shortages.
Hospice and palliative care services that provided hands on and home care services in the community had greater odds of being busier than services that did not provide care in these settings. During the Covid-19 pandemic, there was a shift in patient and family preferences as visiting restrictions and fear of infection meant many people preferred to remain at home rather than go to hospitals or to inpatient hospice units, and deaths in inpatient hospices fell, while home deaths rose.
With more people choosing to remain at home, services providing care in the community may have been able to respond to these changes in preferences. This is in keeping with findings from a survey of General Practitioners and District Nurses, which found that primary care teams provided both higher volume and higher complexity of community palliative care during the pandemic. Services that were publicly managed had greater odds of being busier compared to services that were charitably managed. In the United Kingdom, only 30% of hospice funding overall is from public/government sources, with 70% from charitable sources.
Being busier was associated with services that provided community care, and those that were publicly managed. This may indicate that service and funding models influence the ability of hospices and palliative care services to respond rapidly to changing needs and priorities. The study provides a starting point for further research, exploring the ability of hospice and palliative care services to respond rapidly to changing patient preferences and societal needs.
Sleeman, K. E., Cripps, R. L., Murtagh, F. E. M., Oluyase, A. O., Hocaoglu, M. B., Maddocks, M., Walshe, C., Preston, N., Dunleavy, L., Bradshaw, A., Bajwah, S., Higginson, I. J., & Fraser, L. K. (2022). Change in Activity of Palliative Care Services during the Covid-19 Pandemic: A Multinational Survey (CovPall). Journal of palliative medicine, 25(3), 465-471. https://doi.org/10.1089/jpm.2021.0315