Leading a project on the impact of hospice care on hospital use at the end of life

Hospice UK has had a long-standing interest in the potential contribution that hospice care can make in reducing the number of people dying in a hospital bed who have no clinical need or wish to be there. 

Around the country, hospices are already leading a range of initiatives that seek either to prevent avoidable unwanted admission to hospital for people approaching the end of life, or facilitate the appropriate and timely transfer of hospital patients who have no clinical need or wish to be in a hospital bed, often by working in creative ways with other services.

But little is known about the critical factors that contribute to the success of these initiatives, and even less is known about their cost effectiveness, or the extent to which these initiatives can be replicated more widely to achieve a significant impact on the experiences that people have at the end of life.
Hospice UK has been commissioned by NHS England to lead a new project to examine this in more detail. The HOLISTIC (Hospice Led Innovation Study To Improve Care) project will involve careful analysis of a number of hospice-led initiatives around England that appear to be having a positive impact on where people are cared for as well as where they die.

Data processing for the HOLISTIC project

A quantitative study, as part of the HOLISTIC project, will analyse the impact on patients’ care of hospice-led innovations using nationally collected hospital episode data. The hospital records associated with cohorts of patients who died between 2010 and 2017, and could have been impacted by these care innovations, will form the basis of this evaluation. The focus will be on measuring where people die, and their usage of hospital services in the last 90 days of life, with the aim of measuring the reduction in hospital bed usage that these care innovations have made.

Hospice UK and NHS England are joint data controllers for these activities. Approval for using identifiable data to select patient cohorts has been given under section 251 of the NHS Act 2006.

Further information

Contact the team for further information about the HOLISTIC project.

What does hospice care mean to you?