Title: Building multi professional UK partnerships and networks to improve access to palliative care for people experiencing homelessness
Funder: Department of Health and Social Care

Abstract: Background_x000D_ People experiencing homelessness often have very poor health and don’t access healthcare in the same way as housed people. Many people experiencing homelessness die at a young age, in their mid-40s, and there often isn’t much planning around the care they receive at the end of life. Palliative care services don’t usually support this group as it’s often hard to know when the right time for palliative care support to begin would be. This group may have quite different needs to people that palliative care services might support._x000D_ Because its hard to know how best to support someone experiencing homelessness towards the end of their life, a lot of different professionals need to be involved. This doesn’t often happen. For people who live in homeless hostels, staff working there are usually their main source of support, but they have no healthcare training. _x000D_ In our research, our work as clinicians or people who support those facing homelessness, we know that people are doing excellent work to support this group at the end of their lives. These people aren't connected so opportunities to share ideas, do research and support each other are lost._x000D_ _x000D_ Aims_x000D_ We want to make a nationwide network to connect people from different backgrounds who are interested in palliative care for people experiencing homelessness, including people with experience of homelessness to share ideas, support each other and develop research to make support better. By bringing together people skilled and experienced in research in this area and people skilled in supporting people facing homelessness, but who don’t have much research experience we can improve the skills of people from different backgrounds to make research and practice better._x000D_ _x000D_ Methods _x000D_ We will use a system called Project ECHO to arrange monthly online meetings connecting all these people. We will run workshops with people with lived experience of homeless to make sure they are involved in a way they are comfortable with._x000D_ _x000D_ We will interview network members about work in their local areas aiming to improve palliative care for people experiencing homelessness, and share our findings. We will together decide what the most important research questions about palliative care and homelessness are and use this to write a research funding application._x000D_ _x000D_ We will also ask network members (including those with lived experience) how best to involve people with experience of homelessness in palliative care research. This will help us to write guidelines to share with other researchers._x000D_ Impact _x000D_ We believe we are stronger together. Creating a network to share best practice and experiences will help us work together to improve the care that people experiencing homelessness receive towards the end of their lives._x000D_ By bringing together people from different professional backgrounds, some of whom are skilled researchers, others very experienced in working in homelessness or health care settings, and others who have lived experience of homelessness, we will learn from each other and find out what needs to change for homeless people to receive better care towards the end of life_x000D_ _x000D_ Together we will produce a funding proposal with the potential for real world impact, a guide for involving people facing homelessness in research, research priorities and our learnings about creating a network like this. This will promote the inclusion of people with lived experience to make future research stronger

Lay abstract: Background_x000D_ People experiencing homelessness have high rates of multi-morbidity and age related conditions at a young age and die young. The lack of palliative care support and appropriate places of care means very unwell people with complex problems are often supported by homelessness staff, with hospitals used instead of more appropriate community support. In order for people affected by homelessness to receive high quality care, multi-professional input is required, but rare._x000D_ There is increasing awareness across the health and social care sector of a need to improve access to palliative care for this group. However, no central network exists whereby those with clinical, research or lived experience can share ideas, resources and learning to explore and reduce current inequity._x000D_ _x000D_ Aims:_x000D_ •Create a sustainable partnership of practitioners, researchers and people with lived experience of homelessness to drive enthusiasm for research, promote shared learning and a multidisciplinary approach to care for this group towards the end of life_x000D_ •Understand and expand research scope and capacity in this sphere by involving those experienced in palliative care and/or homelessness work but with limited research experience and those with opposite skill set_x000D_ •Identify from the network research priorities_x000D_ •Develop a funding proposal for the NIHR Palliative and End of Life Care stage 2 call _x000D_ _x000D_ Objectives_x000D_ •Connect people from different backgrounds, with lived experience of homelessness, or whose work touches palliative care in a national network using Project ECHO_x000D_ •Map current research and best practice_x000D_ •Match people with suitable academic or practice experience as partners to build capacity (buddying)_x000D_ •Produce guidance to support involving people with lived experience of homelessness in palliative care research_x000D_ •Facilitate peer led workshops for people experiencing homelessness_x000D_ •Use Deep Inclusion Methodologies to identify research priorities_x000D_ •Share learning to enable wider system-learning including how NIHR infrastructure could support community based research_x000D_ _x000D_ Methods_x000D_ This innovative project aims to unite the diverse field of research and practice surrounding palliative and homelessness. Its multi-professional, multi-site nature will generate unique insights, connections and opportunities for coproduced, impactful research and improved care. The applicants are those with track records of research and impact in this sphere, of involving homeless people in research or are at the forefront of practice._x000D_ _x000D_ Project stages_x000D_ 1.Identify potential network members – using professional networks and online engagement events_x000D_ 2.Establish a sustainable network to support cohesion, co-learning, identification and prioritisation of research questions and guidance for research in this field. This will be undertaken via Project ECHO (Extension for Community Healthcare Outcomes) and peer led workshops to map current research and clinical activity across the UK, identify and prioritize research questions with real world importance and develop guidance for involving people with lived experience of homeless in palliative care research_x000D_ 3.Coproduce a research proposal for the stage 2 call based on a research question prioritised by the network and where there is a known evidence gap_x000D_ _x000D_ Potential impact _x000D_ We will deliver cohesion, mutual learning, collegiate support and collective power to an important but disconnected area of research and practice

Research activity codes: 7.2 END OF LIFE CARE
Health categories: GENERIC HEALTH RELEVANCE