Contributions to Palliative and End‐of‐Life Care by Community Health Nursing Services: Improving Care Through National and Regional Service Evaluations
4 affiliations
- 1Wolfson Palliative Care Research Centre, Hull York Medical School University of Hull Hull UK
- 2Birmingham Community Healthcare NHS Foundation Trust Birmingham UK
- 3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation King's College London London UK
- 4Sussex Community NHS Foundation Trust Brighton UK
Abstract
Aim(s): To evaluate adult palliative and end‐of‐life care provision in England by community health nursing services using a national dataset (2013–2024) to report patterns in service provision over time and a regional dataset (2022/23, 2023/24 and 2024/25) to describe palliative and end‐of‐life care activities.
Design: Secondary analyses of existing national and regional datasets.
Methods: We used national data to evaluate the populations served; workforce; referrals; unique service users seen annually; contacts; time on caseload; care delivered/care locations; support to other teams/processes; and deferred care. Regional data was used to examine palliative and end‐of‐life care activities in the context of all nursing care delivered.
Results: Nationally, referrals to community health nursing services increased steadily from ~4,000 to ~6,000 per 100,000 weighted population between 2013 and 2024, while unique service users remained stable (around 2,600–2,800). Median average time on caseload reduced markedly from over 150 days to around 50 days, despite stable contact frequency (median 23 total contacts per service user) and duration (median 28 min for face‐to‐face contacts). Regional data showed that palliative and end‐of‐life care consistently accounted for 9.6% of all community nursing clinical time (30–32 h per 1,000 population annually) across 3 years, even as total care hours declined. A disproportionate amount of palliative and end‐of‐life care occurred out‐of‐hours.
Conclusion: Increasing referrals and shorter time on caseloads indicate a system under pressure. Time spent on palliative and end‐of‐life care by community health nursing teams has remained stable over time, despite growing population need. Workforce capacity, skill mix and out‐of‐hours provision need to align to support high‐quality, person‐centred care in the community.
Implications for the Profession and/or Patient Care: This evidence informs better planning to ensure sufficient provision and workforce in community health nursing.
Patient and Public Contribution: Patients, family carers and public members contributed to interpreting findings and implications for practice.
Related
- Improving the detection, assessment, management and prevention of delirium in palliative care units (the DAMPen-Delirium II study): protocol for an implementation-to-target Type III hybrid effectiveness-implementation cluster randomised-controlled trial, economic evaluation and process evaluation of the Creating Learning Environments for Compassionate Care-Palliative (CLECC-Pal) implementation strategy.
- Meeting the needs of people with pulmonary fibrosis: patient perspectives on improving palliative care provision: a qualitative study
- Socioeconomic status and temporal trends in unmet needs for community-based home visiting services among disabled older adults in China
- Knowledge of community services among clinicians who care for patients with dementia
- Building recovery capital: co-creating an assets-based community engagement toolkit for people accessing drug and alcohol treatment services
BibTeX
@article{pask2026contributions,
title = {{Contributions to Palliative and End‐of‐Life Care by Community Health Nursing Services: Improving Care Through National and Regional Service Evaluations}},
author = {Sophie Pask and Assem Khamis and Tina Jarrett and Joanna M. Davies and Catherine J. Evans and Fliss E. M. Murtagh},
journal = {Journal of Clinical Nursing},
year = {2026},
month = aug,
doi = {10.1111/jocn.70476},
url = {https://doi.org/10.1111/jocn.70476},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Contributions to Palliative and End‐of‐Life Care by Community Health Nursing Services: Improving Care Through National and Regional Service Evaluations
AU - Sophie Pask
AU - Assem Khamis
AU - Tina Jarrett
AU - Joanna M. Davies
AU - Catherine J. Evans
AU - Fliss E. M. Murtagh
PY - 2026
DA - 2026/08/06
JO - Journal of Clinical Nursing
DO - 10.1111/jocn.70476
UR - https://doi.org/10.1111/jocn.70476
AB - Aim(s): To evaluate adult palliative and end‐of‐life care provision in England by community health nursing services using a national dataset (2013–2024) to report patterns in service provision over time and a regional dataset (2022/23, 2023/24 and 2024/25) to describe palliative and end‐of‐life care activities. Design: Secondary analyses of existing national and regional datasets. Methods: We used national data to evaluate the populations served; workforce; referrals; unique service users seen annually; contacts; time on caseload; care delivered/care locations; support to other teams/processes; and deferred care. Regional data was used to examine palliative and end‐of‐life care activities in the context of all nursing care delivered. Results: Nationally, referrals to community health nursing services increased steadily from ~4,000 to ~6,000 per 100,000 weighted population between 2013 and 2024, while unique service users remained stable (around 2,600–2,800). Median average time on caseload reduced markedly from over 150 days to around 50 days, despite stable contact frequency (median 23 total contacts per service user) and duration (median 28 min for face‐to‐face contacts). Regional data showed that palliative and end‐of‐life care consistently accounted for 9.6% of all community nursing clinical time (30–32 h per 1,000 population annually) across 3 years, even as total care hours declined. A disproportionate amount of palliative and end‐of‐life care occurred out‐of‐hours. Conclusion: Increasing referrals and shorter time on caseloads indicate a system under pressure. Time spent on palliative and end‐of‐life care by community health nursing teams has remained stable over time, despite growing population need. Workforce capacity, skill mix and out‐of‐hours provision need to align to support high‐quality, person‐centred care in the community. Implications for the Profession and/or Patient Care: This evidence informs better planning to ensure sufficient provision and workforce in community health nursing. Patient and Public Contribution: Patients, family carers and public members contributed to interpreting findings and implications for practice.
SN - 0962-1067
SN - 1365-2702
ER -