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C-CHANGE: Delivering quality and cost-effective care across the range of complexity for those with advanced conditions in the last year of life.

The long-term aims of the C-CHANGE project were to develop and validate a patient-centered, nationally applicable casemix classification for adult palliative care provision. This classification will reliably reflect the complex needs and concerns of patients and families, in order to enable the delivery of better quality and more efficient care in the last year of life.

The C-CHANGE project is now complete and in write-up.

What was C-CHANGE?

This project, led by Professor Murtagh, Professor Higginson, and the research team in the Cicely Saunders Institute, King’s College London, to:

  • Define and measure complexity, so that when a person needs palliative care we can consistently and clearly understand and communicate the complexity of their palliative care needs
  • Measure outcomes in relation to complexity, so that we can really understand and demonstrate what palliative care services are achieving.
  • Develop and validate a patient-centered casemix classification for adult palliative care provision in England.
  • Test different models of palliative care in terms of both effectiveness and cost-effectiveness.

A casemix classification uses a small number of specific criteria (such as phase of illness, functional status and problem severity) to capture and reflect complexity, so that resources can be effectively allocated according to the level of complexity and need, and outcomes appropriately measured.

The C-CHANGE classification is based on clinical complexity, and extends across both cancer and non-cancer advanced conditions, and across community, hospice and hospital settings.

This programme of research ensured that patients across a range of advanced conditions and settings can better receive the appropriate resources according to their individual needs.

The C-CHANGE project was funded by the National Institute for Health Research. Further information about the project can be found on the National Institute for Health Research website.

The team has now dispersed but remaining members include:

Contact Us:

To find out more about the C-CHANGE project and our current research please contact the project administrator via any of the methods below and we will endeavour to get back to you as soon as possible:

Telephone: 0207 848 5537
Email: Fern Brookes
Post: C-CHANGE Team
Department of Palliative Care, Policy & Rehabilitation
Cicely Saunders Institute
Bessemer Road
London SE5 9PJ

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