Title: The role of palliative care in place-based care systems
Funder: Marie Curie

Abstract: This short qualitative analysis is designed to secure intelligence and insights from key stakeholders. It will involve: • A short review of policy and emerging place-based care arrangements across Wales to set the context for focus groups. • Focus groups with Marie Curie and partner professionals to explore views on what place-based care should include in palliative care provision. • Interviews with experts through experience (including patients, families, carers and volunteers) to explore views on what place-based care should include in terms of palliative care provision. • On-line focus groups with leaders, commissioners and senior practitioners in Local Health Boards and local authorities to explore how arrangements are changing, and the implications for services in palliative care. • A thematic analysis of the contributions and a final report. All contributions will be anonymised and non-attributed. The study will not require ethic committee approval as we will not draw on individuals direct experience or select contributors to be representative of the overall population, and we will produce a single qualitative analysis of combined contributions. The study is, in effect a specialist market research exercise. It will be subject to equivalent assurance of ethics and quality however, including: • Interviewers with training and experience working within IPC’s interview guidelines. • Screening by Marie Curie senior officers to ensure interviewees are appropriate. • Initial approach from Marie Curie followed up by IPC contact including details of the project, their commitment, confidentiality and security. • A protocol to guide researchers for any circumstances where the interviewee might become distressed. • A clear statement that interviewees can choose not to take part or withdraw their consent or participation at any stage without suffering any effect on their right of access to services or their work with or for Marie Curie. • A clear statement of practice in terms of interview recording, storage and protection

Lay abstract: There are major changes taking place in the design and delivery of local ‘place-based’ health, care and wellbeing in Wales towards: • Shifting care closer to people’s homes. • Seamless services across primary, community and social care. • Place-based systems at GP cluster or locality level. • An emphasis on local community mobilisation to promote wellbeing and support those in need. • Integrated community health and social care budgets and commissioning. These echo many of the changes that are taking place in England and may well presage significant changes in palliative care provision such as • More local community and home-based provision. • Closer working with partner agencies to organise and deliver flexible packages of care. • An emphasis on rapid response and early help through volunteers and community-based workers • Services working more closely with or being contracted through primary care and social care. • New charging and costing models. These developments are emerging, and this project will help Marie Curie to be clearer about what place-based care is likely to mean across Wales (and more widely) in the future, and what implications there will be for commissioning and contracts, service design and delivery, partnership working and public awareness of the Marie Curie brand. It will help Marie Curie Wales to take a position on the role of palliative care and support within wider placed-based care systems, and to influence partners to include best palliative care practice in their local health and care arrangements. The project will draw on existing research and national policy, focus-groups with stakeholders and views of those with lived experience to produce a report and action plan for the Marie Curie leadership team in Wales. The report will also be useful for reference for colleagues working elsewhere in ‘places’ across the UK.

Research activity codes: 7.2 END OF LIFE CARE;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE