65 Rapid response service models in end of life care: what works, for whom and in which circumstances?

Background

Community palliative and end of life care services, such as Rapid Response Services (RRS), facilitate death at home, where that is the patient’s choice. Providing specialist palliative care, they aim to cut the risk of unplanned hospital admissions, minimise delayed discharges, and provide specialist palliative care. Yet, there is little evidence about the impact, and outcomes of different RRS models. This presentation draws on an on-going realist economic evaluation of two discrete RRS in England, designed to evidence who services work for, how, and why.

Methods

Realist evaluation is a theory-driven approach. Through 3 research phases, early suppositions were drawn through literature reviewing and stakeholder discussions. These were then tested and revised through iterative data collection and analysis. Qualitative data collected included semi-structured interviews with RRS staff, external Health and Social Care Practitioners, carers, and patients from both sites (n=’up to’ 55). Quantitative data was concurrently collected to assess the costs and benefits of the different service models.

Results

Data collection and analysis are due to complete Dec-Jan 2023. Preliminary findings demonstrate we will present data of the impact and influence of communication, service values, diagnosis/prognosis, ‘being known’, staff competencies, and hours of service offered. The final quantitative and qualitative data will be combined and presented as final programme theories (PTs) of what works, for who, how, and why.

Conclusion

Final programme theories of what works, for who, in what circumstances, alongside examples of supportive data, will be shared. Also, our recommendations and implications for service design and delivery, developed from research evidence.