Inequities in a service struggling to meet demand: findings from an evaluation of a Hospice at Home service in Cambridgeshire

Jackie Buck, Stephen Barclay, Liz Webb, Lynn Morgan

Research output: Contribution to conferenceAbstractpeer-review


Background: Most people want to die at home. The Arthur Rank House Hospice in Cambridge re-launched its overnight Hospice at Home service in 2011 to provide home based hospice level care for people in Cambridgeshire in the final two weeks of life. This paper describes part of a mixed-methods evaluation to evaluate the nature, scope and equity of the service provision.

Methods: A near time case note survey of all patients referred to the Hospice at Home service for one year from September 2012 (n=315). Quantitative data analysed descriptively, qualitative analysed thematically.

Results: Roles of the service were identified: care co-ordination, specialist 'end of life care' assessment and advice, 'holding' complex patients until hospice beds become available, hands-on nursing care. Demand far outstripped supply. Approximately a third of all episodes of care requested each month were unfulfilled. People cared for by the service were predominantly male (55%). 75% had cancer. Only 10-12% of people who died at home locally with diagnoses other than cancer received support from hospicet at home. 50-60% of people who died at home locally with cancer were supported by the service.

Discussion: The service provides comprehensive nursing care for people at the end of life, however the service is struggling to meet demand. There is potentially huge latent demand. Further research is needed to understand why so few people with diagnoses other than cancer are referred and to identify interventions to make the service more equitable.
Original languageEnglish
Publication statusPublished - 8 Oct 2015
EventCambridge Institute of Public Health Research Conference: Why Public Health Research Matters - University of Cambridge, Cambridge, United Kingdom
Duration: 8 Oct 2015 → …


ConferenceCambridge Institute of Public Health Research Conference
Country/TerritoryUnited Kingdom
Period8/10/15 → …
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