End of Life Doula UK Service Evaluation: Kingston and Richmond NHS Commission

Between December 2023 and September 2024, End of Life Doula UK (EoLDUK), in partnership with the South West London Integrated Care Board (ICB), delivered a project offering community-based end of life doula (EoL doula) support in the London boroughs of Kingston and Richmond. The initiative was funded through the End of Life Care and Frailty Innovation Fund. It aimed to improve experiences at the end-of-life by enhancing advance care planning (ACP), reducing unplanned hospital admissions, and increasing the likelihood of people dying in their preferred place. EoL doulas are trained, non-medical practitioners who offer practical, emotional, and spiritual support to people who are approaching end-of-life and those important to them. EoLDUK practising members are DBS-checked, insured, and work under a code of practice. For this project, 12 EoL doulas supported 25 individuals over varying lengths of time, with referral pathways involving NHS staff, hospice teams, and community self-referrals. Support included ACP facilitation, companionship, advocacy, and respite care.

Executive Summary

Outcome Measure Findings: Unplanned hospital admissions: None of the 25 people supported outside of hospital had an unplanned admission during their final three months of life.

Preferred Place of Death (PPoD): Of those able to express a preference, 92% (12 out of 13) died in their chosen location.

Advance care planning: ACP conversations were initiated with 52% of people, with EoL doulas helping document a range of care and legacy decisions.