Abstract

Best practice to develop and evaluate models of service delivery and complex interventions in palliative and end of life care (EoLC)
This is an innovative project that intends to shape and influence the development and evaluation of palliative and EoL care. Undertaking research in palliative and EoL care faces many practical and ethical obstacles; EoL care is provided by both generalist (e.g. GP, district nurse) and specialist practitioners (e.g. specialist palliative care team); EoL care services offer a wide range of integrated interventions including components of education and clinical guidelines (e.g. Liverpool Care Pathway), direct multi-professional care, as well as more focussed interventions (e.g. cognitive behavioural therapy); EoL care is provided across health and social care settings (e.g. hospital in-patients, care homes); and involves individuals with advanced progressive disease and their families.  

The End of Life Care Strategy in England (Department of Health 2008) asserts that research [on EoL care] is too slow, too expensive and frequently does not come up with results which are useful for policy makers and commissioners (pg 146). There is a clear need for further research in EoL care, and in particular, the Strategy emphasizes the need to develop methods for the evaluation of new service models in end of life care – for example, methods that can be applied routinely to evaluate the many natural experiments that arise in the NHS from service redesign (page 147). This research project intends to identify, appraise and synthesise ‘best practice’ methods for the evaluation of EoL care, particularly focussing on complex service-delivery interventions and reconfigurations. A main output is Methods Guidance on Developing and Evaluating Complex Interventions in Palliative and EoL Care, following a similar format to the MRC Methods Guidance Developing and Evaluating Complex Interventions