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King's College London

HealthSociety

Sustainable care in the future

Background:

  • In England and Wales, there are 35,659 NHS nurses providing community-based services, including palliative and end of life care. This includes community nurses and district nurses, and some with varied specialist qualifications.
  • This nursing workforce delivers a high proportion of community-based palliative and end-of-life care, including out-of-hours, but little is known about the exact extent/nature of their contributions, how much of their time relates to palliative and end-of-life care, levels of integration with other services, or best/innovative models of care. Their support and training needs - to maximise retention of the nursing workforce - are also poorly understood.

Policy relevance:

  • This provides evidence on: palliative and end-of-life care workforce, specific evidence on current and future palliative and end-of-life care nursing workforce, their training needs, recommendations for retention, potential new models of care.

Aims

  • To determine the roles and contributions of district and community nurses to palliative and end-of life care for adults in home and community settings, both now and into the future.
  • To understand optimal and innovative models of care to meet these future challenges.
  • To determine training and support needs of the nursing workforce to optimise retention
  • To deliver system-level policy suggestions to better meet current and future requirements for palliative and end of life care

Methods

Phase 1: A scoping review

  • We will focus on evidence about the district and community nursing workforce; what roles they undertake, what amount of their time is spent on palliative and end of life care, what nursing workforce is projected for the future including anticipated changes (training, retirement, attrition), what is included in ‘in-hours’ and ‘out-of-hours’ care, where the boundary between ‘generalist’ and specialist palliative care lies; and what training and support needs are reported (if any). We will report gaps in this evidence and use this understanding of gaps to inform Phase 2.

Phase 2: Primary data collection

  • This will be informed by Phase 1 and is yet to be determined.
Project status: Ongoing

Principal Investigator