Rapid Conversion Evidence Summary (RaCES) Internship with the Health and Care across the Lifecourse (HaCaL) theme

Background: Quality end-of-life care is vitally important but can be challenging to achieve. Despite recent improvements, there are still areas of weakness, particularly around communication, planning and availability of specialist palliative care (Healthcare Improvement Partnership, 2021). These weaknesses are further exacerbated when experienced by those from lower socio-economic positions.

Research aims and objectives: To improve end of life care of patients from lower socio-economic positions.

Methods: A RaCES project was undertaken to assess the association between socio-economic position and end of life care. A systematic review which explored indicators of socio-economic position and the use of healthcare by those in the last year of life (Davies et al., 2019) was critically appraised and the findings summarised in the context of clinical practice. The findings of the RaCES were used to develop a quality improvement project for the Trust to improve end-of-life care and reduce inequalities.

Patient and public involvement: Engagement and co-design was planned in the development phase of the quality improvement project.

Findings: The RaCES project identified three key points:
• Individuals living in the most deprived areas are more likely to access acute hospital services in the last three months of life and die in hospital rather than at home, compared to those living in the least deprived areas.
• Individuals living in a high area of deprivation or with a lower level of education are less likely to receive specialist palliative care.
• Further research should aim to improve access to appropriate end-of-life care for those identified within a lower socio-economic position.

Potential impact: Improvement in end-of-life care on a local level, and contribution to research and the literature base of end-of-life care in acute settings.

Links:
• ARC NWC Internship Showcase Poster
• Publication – Is a lower socio-economic position associated with poorer outcomes for end-of-life care?

For more information, contact abigail.levison@elht.nhs.uk