How specialist palliative care services have coped in response to COVID-19

Specialist palliative care services have been flexible, highly adaptive and have embraced a low cost ‘frugal innovation’ model in response to the COVID-19 pandemic say researchers. 

The CovPall study, published in Palliative Medicine, is a collaborative project between Hull York Medical School and the University of York, the Cicely Saunders Institute at King’s College London and Lancaster University. 

It aims to understand the multinational specialist palliative care response to COVID-19 through an online survey of more than 450 hospice and specialist palliative care providers.  

Professor Fliss Murtagh, Associate Director of the Wolfson Palliative Care Research Centre and lead author from Hull York Medical School, says: ‘we know that specialist palliative care services are a critical part of the healthcare response to COVID-19, however like many services they have had to adapt in response to the challenges presented by COVID-19'.  

As part of the research, Lesley Dunleavy, Professor Catherine Walshe and Professor Nancy Preston from the International Observatory on End of Life care at Lancaster University led on mapping and analysing the types of innovations and practice changes made by specialist palliative care services in response to the pandemic.  

Examples included;  

• creating a single point of access for patients, family carers and health care professionals,  

• using communication technology to provide clinical care 

• developing COVID-19 symptom control guidelines and providing training in end-of-life care.  

Services reported a number of challenges and concerns when responding to the pandemic that included working within a climate of heightened fear and anxiety, a lack of IT infrastructure, how to sustain out of hours cover without adequate funding and how to keep abreast of the ever-changing situation. There was evidence that services sometimes duplicated guideline and policy development. 

The study highlighted that specialist palliative care services need better financial support but also need to build organisational resilience and drive forward innovation through greater collaboration to manage the impact of the COVID 19 pandemic or any future crisis.  

Fliss goes on to say that: ‘the CovPall study has provided unique insight into palliative care services and their ability to adapt in response to the COVID-19 pandemic - playing a key role in the crisis. However, in order to build long term resilience and sustainability, and ensure services can continue to adapt, greater financial support and international collaboration is needed. We also need to further evaluate the effectiveness and sustainability of any changes made during the crisis.’ 

You can read the full paper on the Palliative Medicine journal website.