Geographical understanding of variation in place of death: the role of care services and end of life care improvement (GUIDE Care Services)
In 2015, Dr Wei Gao and her colleagues at the Cicely Saunders Institute secured a grant from the NIHR Health Service and Delivery Research Programme that will enable them to collect and analyse data from across England. They are investigating the influence that local configurations of health services have on place of death – are there particular service configurations that make it more likely for people to die at home, in hospital, in a care home, or in a hospice?
The study (called Guide_Care Services) was adopted by the CLAHRC South London Executive in September 2015.=
‘It is predicted that the number of deaths will rise from 503,000 a year now to more than 586,000 a year in 2030. To maintain current levels of care, we would need a 20 per cent increase in hospital beds, so we need to start planning now, and identify service configurations that best serve people’s needs. Commissioners and service providers will be able to use that information to modify their services locally in order to meet people’s needs and optimise resoures.’
The national study will compare what services are available in areas that have high numbers of deaths at home, and what services are available in areas that have high numbers of deaths in hospital.
The team will study all deaths that happened over five recent years using data extracted from the National Death Registry Database in England. This information will include place of death, as well as cause of death.
Data about what services are available in a local area will be collected from multiple sources. ‘We will look for information about what type of services are available in a particular area – eg hospital care, palliative and end of life care, primary care and specialist care. We will collect information about the number of care providers, the number of beds available, the size of the workforce, the types of services within hospitals – does a hospital have an A&E for example? We will also collect information about the number of care homes, and the amount of NHS Continuing Healthcare that is awarded within an area to fund care (either in people’s home, in a care home or in a hospice).’
The research started in July 2015 and is due to finish at the end of September 2017. The project’s advisory group includes patients and family members, representatives from the End of Life Intelligence Network, service providers and commissioners.