Rapid evaluation of the COVID-19 pandemic response in palliative and end of life care: national delivery, workforce and symptom management (CovPall)

Lead Research Organisation: King's College London
Department Name: Palliative Care and Rehabilitation

Abstract

The COVID-19 pandemic is placing an unprecedented strain on health care services. Although many people survive, an estimated 1 to 4% die from this disease. There are more than 10,000 UK deaths from COVID-19, with numbers escalating.

Many of the symptoms, such as breathlessness, fever, agitation and pain, are very distressing. But in this new disease these symptoms are not well understood. Palliative care services are adapting rapidly to this situation, but in different ways, not knowing what is best.

This research aims to rapidly evaluate the palliative care response in COVID-19 to improve care now and in the future.

There are two main components, called work packages (WPs), to the research.

WP1 surveys, UK wide, palliative care medical or nursing leads, about their changes in practice, how they deploy the workforce, volunteers and technology, their innovations and challenges.

WP2 collects data about patients' symptoms, how they change over time, and the effects of treatments.

We collect this information immediately and quickly (phase I), and then repeat the data collection after 6-8 weeks (phase II) to understand how practice is changing.

We involve patients, families, the public, policy makers and services in all stages of the research. We release early findings, to help catalyse an effective response.

Technical Summary

COVID-19 has an estimated case fatality ratio between 1-4%; higher among older people and those with underlying illnesses. Information is urgently needed to evaluate the evolving palliative and end of life care response. This knowledge is vital to optimise health care delivery, and to manage symptoms, as no evidence currently exists.

This research aims to rapidly and robustly evaluate the UK palliative care and end of life care response in COVID-19 in terms of services, workforce and symptom management to optimise patient and family care.

Design: Rapid, multicentre observational study, comprising two main work packages.
WP1. Online survey of clinical leads of UK community, hospital and inpatient palliative care and hospice services, to map and understand their workforce and volunteer deployment, innovations, challenges and clinical practices in response to COVID-19.
WP2. Prospective cohort study of the characteristics, symptoms and clinical care experienced by patients within palliative care and hospice services (selected purposively from those responding to WP1), to understand the prevalence and trajectory of symptoms, treatments received, and their effects (benefits, any harms).

Both WPs run initially (phase I) and are repeated (phase II) after 6-8 weeks. This examines practice changes, successes and difficulties. In addition, in phase II we integrate case studies of successful innovations and challenges, that provide in-depth insights.

Active policy, patient and public engagement is incorporated in all phases of the research, including with charitable and statutory bodies, NHS England, Public Health England, and our NIHR/ARC supported virtual Patient and Public Palliative Care forum.

Publications

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Bajwah S (2020) Managing the supportive care needs of those affected by COVID-19. in The European respiratory journal

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Blum D (2023) Top Ten Tips Palliative Care Clinicians Should Know About Cachexia. in Journal of palliative medicine

 
Description CovPall is a multinational observational study of specialist palliative services response to the COVID­-19 pandemic. Two main work packages collecting data at service level (from 458 services, 277 UK) and patient level data (572 patients).

Data from 458 palliative and end-of-life care services in the UK and across the world showed:
•Most services were overwhelmed by people with COVID, also looked after their existing patients
•Community and hospital palliative care teams had a large surge in patients - 91% of services changed how they worked
•The importance and role of palliative care in the pandemic response, particularly for charity managed services and those providing care in people's homes

Key messages:
•Palliative care services supported people during the COVID pandemic
•Palliative care developed 'frugal innovations' to care for more people
•Improvements were seen even when patients had less than 2 days in care
•Moderate to severe breathlessness, agitation and more than one pre-existing health condition as potential triggers to prioritise future referrals
•Practice changes such as equality impact assessments could address inequity
•The impact of COVID on individuals was severe
•Patients deteriorated very quickly; within 48 hours of the first assessment, more than 50% of the patients referred had died
•Differences in symptom severity between final and initial assessments, shows improvement of breathlessness, pain and anxiety

The CovPall Study influenced policy, planning and practice for the future epidemics informing key reports (for example Marie Curie reports) and key discussions (parliamentary, NHS England), highlighting palliative care's critical role in an effective and integrated pandemic response to meet public needs and priorities.
Exploitation Route Our project contributed to the research ecosystem catalysing additional CovPall studies to improve and boost findings in care homes (CovPall Care Homes), national data linkage (CovPall Connect), and rehabilitation (CovPall Rehab). Most importantly, it has demonstrated the enthusiasm to share learnings and contribute to understanding of patient-centered outcomes, even at the toughest of times.

•Further studies could investigate how palliative care evidence generated by the many outputs from the CovPall project could be integrated into policy; in part, because palliative care is often misunderstood and its role is unrecognised.
•An improved understanding of modern palliative care, and its application in different disciplines, could benefit people with different or multiple health conditions, often with complex needs, serious illness and/or symptoms, supporting those close to the patient, such as the family members or friends.
•Further work could be undertaken to integrate referral to palliative care services into care pathways, avoiding late or missed referrals, or a failure to use appropriate treatments that could alleviate symptoms.

Currently we have launched with the Medical Research Foundation a project called CovPall Partners to transform the key evidence generated from CovPall. This aims to transform the understanding and integration of palliative care evidence so more people can benefit in a long-lasting way. We will co-design and share information about the main evidence of the CovPall study, including how to best manage symptoms.
Sectors Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice

URL https://www.kcl.ac.uk/research/covpall
 
Description Our study highlighted that, in general, community and hospital palliative care teams had a large surge in patients to care for. 91% of services changed how they worked. Our findings highlighted the importance and role of palliative care in the pandemic response, particularly for charity managed services and those providing care in people's homes. Parallel planning approach was needed for patients with uncertain trajectories. We proposed that free-standing inpatient palliative care units could in the future pandemics support the community and hospital palliative care teams or care homes.  •In addition to service data, we also worked with 25 NHS and non-NHS sites across England and Wales and collected data on patients severely ill and dying with COVID. Patients deteriorated very quickly; within 48 hours of the first assessment, more than 50% of the patients referred had died. This provided insights and evidence of the severity of impact of COVID on the quality of life of patients with severe COVID. •Differences in symptom severity between final and initial assessments, captured by our patient-centred outcome tools adapted for COVID (IPOS-COV), shows improvement of symptoms such as breathlessness, pain and anxiety in patients seen by palliative care teams that may have been missed otherwise. Improvements in these symptoms were apparent even when patients had less than 2 days in care. Moderate to severe breathlessness, agitation and more than one pre-existing health condition could act as triggers to prioritise future referrals. •Restricted visiting and communication challenges impacted disproportionately on ethnic minority groups. Findings identify need for equitable (not just equal) palliative care response. Outputs have underlined that step changes such as equality impact assessments could effectively address inequity. •Recognition and integration of palliative care into the NHS, particularly for charity managed services and those providing care at home, is vital in improving effectiveness of public services. •A parallel planning approach in uncertain trajectories, taking into account different outcomes that may happen, and discussing options is relevant. •The role of free standing inpatient palliative care units should be re-evaluated in future waves: staff could be diverted to community/hospital palliative care teams/care homes, and could provide step down care from hospitals. Services were flexible and highly adaptive, adopting a 'frugal innovation' model: they used, adjusted and recombined existing resources, structures and processes to deliver care in an more economically viable approach. Many services reported being more busy than before the pandemic. Busyness was consequence of: - Shifting resources in response to needs - Telephone and remote working - Educating, upskilling and supporting The CovPall project has led to many further academic studies, which are continuing to generate rich and valuable research activity: The CovPall-Connect Project combined survey data from the original CovPall project with nationally routinely collected data from the four nations of the United Kingdom, providing an opportunity for national data linkage in ecological analysis, primarily regional, and by setting, of the palliative care response to COVID-19. Data assets have informed major policy documents, such as the Marie Curie better end of life report 2022. CovPall-Connect data showed that home deaths increased for everyone in the UK, but the increase was greater for those living in the least deprived areas compared to those living in the most deprived areas. A gradient in the proportion of home deaths by area-based deprivation levels was observed in all nations but was strongest in England. CovPall Care Homes - Survey to care home senior team, followed by qualitative interviews and a series of roundtables, highlighting that care homes were essential settings for palliative and end-of-life care, but felt overlooked and undervalued. Ten policy recommendations in five areas:  1.Valuing the role of care homes and care home staff 2.Support for care home managers 3.Workforce development, training and support 4.Integration with primary care and specialist palliative care 5.Digital inclusivity  CovPall Rehab - Reported the Covid-19 pandemic had changed rehabilitation provision. Demonstrated impact of staff on COVID-19 related sick leave and re-deployment to other services; problems accessing resources and equipment (i.e. PPE and rehabilitation equipment); large reductions in referrals, caseload, face to face contacts with patients & family carers; large increase in remote contacts, technologies; and changes in patterns of inequity. CovPall Partners - will involve (1) members of the public, patients and those important to them (2) senior leads in the new structures within health and social care, especially Integrated Care Boards (ICBs) and their system partners, such as local authorities and voluntary, community, faith and social enterprise (VCFSE) organisations, to develop and evaluate easily accessible user friendly free resources for these key groups.
First Year Of Impact 2020
Sector Communities and Social Services/Policy,Digital/Communication/Information Technologies (including Software),Education,Healthcare,Government, Democracy and Justice
Impact Types Cultural,Societal,Economic,Policy & public services

 
Description Cicely Saunders International Action Plan for Better Palliative Care (Jan 2021)
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact You Matter Because You Are You, a seven-point Palliative Care Action Plan that identifies the major challenges now facing the palliative care system, and outlines evidence-based solutions for each of them. Findings from CovPall were included in the Cicely Saunders International Action Plan for Better Palliative Care.
URL https://csiweb.pos-pal.co.uk/csi-content/uploads/2021/01/Cicely-Saunders-Manifesto-A4-multipage_Jan2...
 
Description Influenced training of practitioners and researchers
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact Data was presented to clinicians and researchers on how palliative care and hospice services have been impacted by the covid-19 pandemic and how they responded. These presentations have taken place online and also during the teaching of our MSc students who come from different nations of the world. The information provided have helped clinicians and researchers to understand how the pandemic has affected services, challenges experienced and associated factors. The learning from this study has been disseminated widely and will assist in planning for new waves of this and other pandemics in the future.
 
Description NIHR national cross-ARC Palliative and End of Life Care collaboration. An update for DHSC and NHSE 01 02 2023
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description State-of-Play Report: Palliative Care Delivered During COVID-19, By NHS Improvement, London
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Citation in other policy documents
Impact The report found that hte COVID pandemic challenged the NHS to innovate rapidly to meet the urgent clinical need to treat large numbers of critically ill symptomatic people suffering from this new disease. NHS England and NHS Improvement (London) set up the 'Real Time Evaluation, Learning & Innovation Cell' (Evaluation Cell) to evaluate key service delivery changes and to support evidence-based policy and decision making to inform the regional reset programme. The first report drew heavily on the CovPall study findings. It concerns the 'integrated palliative care teams' element of care delivered during the first wave of COVID-19 in London. It provides a state-of-play synthesis of learnings from End of Life Care (EOLC) and palliative care interventions delivered during the first wave of COVID-19 in London. Regional academic and clinical experts came together in a workshop to deliver two aims - review and recommendations from current practice and identification of a key evaluation research proposal to better inform: 'How do we improve the lives of Londoners with COVID-19 who might be entering their last year of life?' Key findings are: 1. Demands on care and location a. There was huge surge in demand on palliative and end of life care services, in particular hospital palliative care teams and community teams became extremely busy, including those supporting care homes and at home nursing. b. To respond to this need for support services changed how they were working and provided 7 day a week services, many clinical academics provided additional support and staff worked long hours and days. c. Palliative care teams found themselves caring for many different groups of patients: they had their existing patients with progressive illness and families already known to their services and now often trying to reduce face to face contacts; and new patients not previously known to palliative care services and without previous care plans, now seriously ill with COVID-19, some dying from it, especially patients with multiple morbidities. All 42 London palliative care services responding to the CovPall survey cared for patients with COVID-19. d. There was a shift in care with more patients being cared for at home, including wanting to be cared for and to die at home, and fewer being admitted to inpatient palliative care units or hospices, possibly because of fears over visiting restrictions.
URL https://www.england.nhs.uk/london/london-clinical-networks/our-networks/end-of-life-care/end-of-life...
 
Description UK Parliament: Submitted our research to their Areas of Research Interest
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
 
Description An evidence synthesis of holistic services for refractory breathlessness in advanced malignant and non-malignant disease
Amount £128,613 (GBP)
Funding ID HS&DR/16/02/18 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description Better integrating palliative care and improving access through partnerships and co-design across all settings (CovPall - Partners)
Amount £30,484 (GBP)
Funding ID MRF-145-0019-DG-HIGG-C0951 
Organisation Medical Research Council (MRC) 
Department Medical Research Foundation
Sector Charity/Non Profit
Country United Kingdom
Start 02/2023 
End 02/2024
 
Description Clinical Doctoral Research Fellowship (Supervisor)
Amount £269,174 (GBP)
Funding ID ICA-CDRF-2015-01-008 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 07/2016 
End 06/2018
 
Description CovPall: Rapid evaluation of the COVID-19 pandemic response in palliative and end of life care: national delivery, workforce and symptom management
Amount £280,948 (GBP)
Funding ID MR/V012908/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 04/2020 
End 04/2021
 
Description Developing 'frailty fit' pulmonary rehabilitation services for people with chronic obstructive pulmonary disease
Amount £564,969 (GBP)
Funding ID CDF-2017-10-009 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description Development of an educational film to improve the delivery of equitable palliative care to patients and families from ethnically diverse groups
Amount £29,166 (GBP)
Funding ID MRF-145-0015-DG-BAJW-C0926 
Organisation Medical Research Council (MRC) 
Department Medical Research Foundation
Sector Charity/Non Profit
Country United Kingdom
Start 07/2022 
End 09/2023
 
Description Doctoral Research Fellowship (Co-applicant)
Amount £257,949 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2020
 
Description Evaluation of the Covid-19 pandemic response in palliative and end of life care: Connecting to boost impact and data assets (CovPall-Connect)
Amount £49,994 (GBP)
Funding ID HDRUK2020.145 
Organisation Health Data Research UK 
Sector Private
Country United Kingdom
Start 01/2021 
End 06/2021
 
Description Marie Curie Research Grants Scheme
Amount £288,437 (GBP)
Organisation Marie Curie 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2016 
End 08/2019
 
Description Marie Curie Research Grants Scheme
Amount £457,400 (GBP)
Organisation Marie Curie 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2016 
End 12/2018
 
Description Minimal versus specialist equipment in the delivery of pulmonary rehabilitation: a randomised controlled trial.
Amount £346,450 (GBP)
Funding ID PB-PG-0816-20022 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description NIHR Clinical Doctoral Research Fellowship
Amount £269,174 (GBP)
Funding ID ICA-CDRF-2015-01-008 
Organisation National Institute for Health Research 
Department NIHR Fellowship Programme
Sector Public
Country United Kingdom
Start 06/2016 
End 05/2019
 
Description NIHR Clinical Trials Fellowship
Amount £40,167 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 11/2014 
End 08/2015
 
Description NIHR Cross-Programme Research partnership on functional loss and rehabilitation towards the end of life
Amount £99,270 (GBP)
Funding ID NIHR135171 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description NIHR Doctoral Research Fellowship (Supervisor)
Amount £240,074 (GBP)
Funding ID DRF-2014-07-089 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 01/2015 
End 12/2018
 
Description NIHR Doctoral Research Fellowship (Supervisor)
Amount £240,074 (GBP)
Funding ID DRF-2014-07-089 
Organisation National Institute for Health Research 
Department NIHR Fellowship Programme
Sector Public
Country United Kingdom
Start 09/2015 
End 08/2018
 
Description NIHR Research for Patient Benefit
Amount £287,403 (GBP)
Funding ID NIHR201060 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description National Institute of Health Research Flexibility and Sustainability Funding
Amount £11,004 (GBP)
Organisation National Institute for Health Research 
Department NIHR Clinical Research Network (CRN)
Sector Academic/University
Country United Kingdom
Start 01/2014 
End 04/2014
 
Description PRP (PCR-01-C19) Stage 2 Recovery, Renewal, Reset: Research to inform policy responses to COVID-19
Amount £181,764 (GBP)
Funding ID NIHR202326 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 01/2021 
End 12/2021
 
Description Post-Doctoral Fellowship
Amount £311,744 (GBP)
Funding ID PDF-2011-04-048 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 11/2011 
End 10/2014
 
Description Rapid funding call to use and enrich the data within the Data & Connectivity National Core Study (NCS) capability
Amount £49,994 (GBP)
Funding ID HDRUK2020.145 
Organisation Health Data Research UK 
Sector Private
Country United Kingdom
Start 01/2021 
End 06/2021
 
Description Rapid review of service delivery models for older people at the end of life to maximise quality of life
Amount $43,900 (USD)
Organisation World Health Organization (WHO) 
Department Kobe Centre
Sector Public
Country Japan
Start 09/2017 
End 12/2017
 
Description Roy Castle Lung Cancer Foundation Project Grant
Amount £34,325 (GBP)
Organisation Roy Castle Lung Cancer Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2014 
End 01/2016
 
Description The Dunhill Medical Trust Research Grant - Understanding the social determinants of outcomes important to older people at the end of life: reducing social inequality in palliative care
Amount £170,406 (GBP)
Funding ID RTF74/0116 
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 11/2016 
End 10/2019
 
Description All Ireland Institute of Hospice and Palliative Care 
Organisation All Ireland Institute of Hospice and Palliative Care
Country Ireland 
Sector Charity/Non Profit 
PI Contribution Dissemination of findings. Providing clinicians with the opportunity to share their experiences of delivering palliative care during the pandemic.
Collaborator Contribution Dissemination of the CovPall survey among their networks to facilitate recruitment.
Impact Clinicians; healthcare workers
Start Year 2021
 
Description Collaboration with NHS Improvement London 
Organisation NHS London
Country United Kingdom 
Sector Public 
PI Contribution wider dissemination and implementation and sharing of the findings in conferences and other settings, for policy makers and ICSs
Collaborator Contribution sharing our materials and convening meetings
Impact Internal reports for the team
Start Year 2021
 
Description EAPC 
Organisation European Association for Palliative Care (EAPC)
Country Italy 
Sector Public 
PI Contribution Delivery of blogs, evidence and information for services to improve care
Collaborator Contribution raised awareness of our reserach and survey - sent it on to country partners
Impact Series of blogs, raised awareness of survey and gained responses
Start Year 2020
 
Description European Association of Palliative Care (EAPC) 
Organisation European Association for Palliative Care (EAPC)
Country Italy 
Sector Public 
PI Contribution Writing blogs for the EAPC platform to disseminate findings from the CovPall survey.
Collaborator Contribution Disseminating the CovPall survey to their networks to give clinicians the opportunity to share their experiences of delivering palliative care during the pandemic. Supporting recruitment. Dissemination of findings.
Impact EAPC blogs Clinicians; healthcare professionals; researchers
Start Year 2021
 
Description Hospice UK 
Organisation Hospice UK
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Contribution to ECHO meetings, and contribution by Hospice Uk to disseminating the work
Collaborator Contribution Very active engagement in all aspects of the research to benefit palliative care and hospice. Rapid practice changes.
Impact Multiple interdisciplinary Hospice UK Echo meets and ongoing plans
Start Year 2020
 
Description Hospice UK 
Organisation Hospice UK
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Updating clinical teams
Collaborator Contribution organising the zoom meetings and inviting us
Impact Multidisciplinary, doctors, nurses, APHs, social work -
Start Year 2020
 
Description Marie Curie 
Organisation Marie Curie
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Including findings from the CovPall study in the Better End of Life Report 2021.
Collaborator Contribution Dissemination of findings in the Better End of Life Report 2021 and increased media coverage of findings through Marie Curie.
Impact Better End of Life Report 2021.
Start Year 2021
 
Description Scottish Partnership for Palliative Care 
Organisation Scottish Partnership for Palliative Care
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Dissemination of findings. Providing clinicians with the opportunity to share their experiences of delivering palliative care during the Covid-19 pandemic.
Collaborator Contribution Dissemination of the CovPall survey among their networks to support recruitment in Scotland.
Impact Clinicians; healthcare workers
Start Year 2021
 
Description Sue Ryder 
Organisation Sue Ryder
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Dissemination of study findings. Opportunities for hospices to share their experiences of delivering palliative care during the Covid-19 pandemic.
Collaborator Contribution Dissemination of the CovPall survey to Sue Ryder hospices to facilitate and support recruitment of the study.
Impact Clinicians
Start Year 2021
 
Description Together for Short Lives 
Organisation Together for Short Lives
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Dissemination of study findings. Opportunities for hospices to share their experiences of delivering palliative care during the Covid-19 pandemic.
Collaborator Contribution Disseminating the survey among their networks to facilitate recruitment for the CovPall study.
Impact Clinicians; healthcare professionals; charity sector
Start Year 2021
 
Description University of Sheffield 
Organisation University of Sheffield
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaboration with Dr Sarah Mitchell at the University of Sheffield to support her to develop a survey of GP and primary care services response to the Covid-19 pandemic.
Collaborator Contribution Expanding the CovPall study to GPs and primary care services. Dissemination of findings.
Impact Research article. Community end-of-life care during the COVID-19 pandemic: findings of a UK primary care survey. https://bjgpopen.org/content/5/4/BJGPO.2021.0095.full Researchers; GPs; primary care workers.
Start Year 2021
 
Description 'A year of fighting the racial inequality of COVID' Blog on EAPC Website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dr Sabrina Bajwah, Clinical Senior Lecturer, King's College London and Honorary Palliative Care Consultant at King's College Hospital, completed a blog post on the European Association of Palliative Care's website titled: 'A year of fighting the racial inequality of COVID', discussing the CovPall study and palliative and hospice care response to COVID-19.
Year(s) Of Engagement Activity 2021
URL https://eapcnet.wordpress.com/2021/09/16/a-year-of-fighting-the-racial-inequality-of-covid/
 
Description 'Role and Response of hospital palliative care during the COVID-19 Pandemic' Blog on EAPC Website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Project members Prof Irene Higginson and Dr Mevhibe Hocaoglu completed a blog post on the European Association of Palliative Care's website titled: 'Role and Response of hospital palliative care during the COVID-19 Pandemic', with links to the CovPall and CovPall-Connect studies.
Year(s) Of Engagement Activity 2021
URL https://eapcnet.wordpress.com/2021/04/21/role-and-response-of-hospital-palliative-care-during-the-co...
 
Description 'The challenges of caring for people dying from COVID-19' Blog on EAPC Website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Project member Dr Adejoke Oluyase completed a blog post on the European Association of Palliative Care's website titled: 'The challenges of caring for people dying from COVID-19', discussing findings of the CovPall study.
Year(s) Of Engagement Activity 2021
URL https://eapcnet.wordpress.com/2021/03/08/the-challenges-of-caring-for-people-dying-from-covid-19/
 
Description 16th Norwegian Conference in Palliative Care 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited presentation with CovPall and CovPall-Rehab data.
Year(s) Of Engagement Activity 2021
 
Description A presentation at Cicely Saunders International Annual lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of key findings emerging from the CovPall study.
Year(s) Of Engagement Activity 2020
 
Description A presentation at Hospice UK ECHO call 18/08/2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Over 100 health professionals from hospice and palliative care services attended an online ECHO call. This sparked questions and discussion around interpretation of findings.
Year(s) Of Engagement Activity 2020
 
Description A presentation at National NIHR Applied Research Collaboration Palliative and End of Life Care Collaboration meetings/workshops 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Over 200 delegates attended the National NIHR Applied Research Collaboration Palliative and End of Life Care Collaboration meetings. Professor I J Higginson presented CovPall study findings. This sparked questions and discussions around study findings.
Year(s) Of Engagement Activity 2020
 
Description A presentation at National NIHR Applied Research Collaboration Palliative and End of Life Care Collaboration meetings/workshops 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Over 200 delegates attended the National NIHR Applied Research Collaboration Palliative and End of Life Care Collaboration meetings. Professor I J Higginson presented CovPall study findings. This sparked questions and discussions around study findings.
Year(s) Of Engagement Activity 2020
 
Description A presentation to the Department of Health and Social Care 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Professor Sleeman presented the CovPall findings to the Department of Health and Social Care along with other Covid-19 research.
Year(s) Of Engagement Activity 2021
 
Description A talk at Dept Health and Social Care 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Invited by DHSC to present about research in Covid-19 / palliative care. Included data from several studies including CovPall, CovPall_Connect, CovPall_CareHomes, Marie Curie Better End of Life.
Year(s) Of Engagement Activity 2021
 
Description ARC South London- Inside Research Seminar. Presentation of CovPall inequality data 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Presentation to clinicians, patients, public and policy makers of CovPall inequalities data followed by breakout rooms with discussion
Year(s) Of Engagement Activity 2021
 
Description Addressing racism in palliative care- keynote lecture at Hospice UK conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact key note lecture at Hospice UK conference. Audience comprised health professionals across all settings. The presentation sparked debate at the conference and on social media
Year(s) Of Engagement Activity 2021
 
Description BBC News Article including findings from CovPall 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A BBC News article which included findings from the CovPall study as part of the Better End of Life programme.
Year(s) Of Engagement Activity 2021
URL https://www.bbc.co.uk/news/uk-56669015
 
Description Better commissioning for palliative care during and after Covid-19 - ARC SL Policy Event 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Policy event on the CovPall and CovPall-Connect studies, discussing how we to promote better commissioning for palliative care during and following the pandemic. The presentations covered the response of palliative care during Covid-19 and reflections on palliative and end of life commissioning and clinical networks.
Year(s) Of Engagement Activity 2021
URL https://www.arc-sl.nihr.ac.uk/events-training/forthcoming-events-training/better-commissioning-palli...
 
Description Blog on the challenges of caring for people dying from covid-19 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I prepared a blog for the European Association for Palliative Care (EAPC) on the challenges of caring for people dying from covid-19. This blog has reached national and international stakeholders through the EAPC platform.
Year(s) Of Engagement Activity 2021
 
Description Blog on the role of palliative care and hospices in the covid-19 pandemic 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We prepared a blog for the European Association for Palliative Care (EAPC) based on a rapid review on the role of palliative care and hospices in the covid-19 pandemic. Our blog reached national and international stakeholders and was in the top ten most-viewed posts published in the first six months of 2020, with more than 18,000 views.
Year(s) Of Engagement Activity 2020
 
Description COVID's Global Impact on Palliative Care: Creating Connections - IPOS Society Event 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Team Members Professor Irene Higginson and Dr Mevhibe Hocaoglu spoke at the IPOS Palliative Care Special Interest Group Education Sub-Committee special webinar and roundtable panel discussion on the impact of the global COVID-19 pandemic on the field of palliative care held Thursday, October 21.

In this webinar, an international panel of Palliative Care experts presented the latest information about the pandemic and how it is impacting the health of individuals, families, communities and palliative care providers.
Year(s) Of Engagement Activity 2021
URL https://www.ipos-society.org/News/10961158
 
Description Cyprus Forum 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Over 1000 people attended the public engagement event. Dr Hocaoglu hosted a discussion on End of Life Care in a pandemic and post-pandemic period.
Year(s) Of Engagement Activity 2021
 
Description Cyprus Newspaper Article 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Dr Hocaoglu published a newspaper article in Cyprus entitled '...you matter to the end of your life.'
Year(s) Of Engagement Activity 2021
URL https://www.yeniduzen.com/herkes-yasaminin-sonuna-kadar-onemlidir-142254h.htm
 
Description EAPC blog on fighting racial inequality 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact blog on a year of fighting racial inequality of COVID with this piece of work highlighted
Year(s) Of Engagement Activity 2021
URL https://eapcnet.wordpress.com/2021/09/16/a-year-of-fighting-the-racial-inequality-of-covid/
 
Description Hospice UK Clinical ECHO Network Session - (10/02/2021) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Prof Irene Higginson discussed the action plan for better palliative care and announced the CovPall-Connect study at Hospice UK Clinical ECHO Network Session.
Year(s) Of Engagement Activity 2021
 
Description Hospice UK ECHO call 11/11/2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Hospice UK echo call attended by hospice and palliative care services, which sparked questions and discussions afterwards surrounding service level and patient level data from CovPall. This increased interest in the study.
Year(s) Of Engagement Activity 2020
 
Description Jean Shanks Lecture 2020 of The Academy of Medical Sciences 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof J Higginson presented the 2020 Jean Shanks Lecture. The lecture considered key facets relevant to palliative care for the 21st century, including: the changing patterns of need, illnesses and symptoms, the challenges of living with and caring in uncertainly, the role of technologies, as well as recent and likely future discoveries and advances in palliative care that could improve the lives of those affected by serious and/or progressive illnesses.
Year(s) Of Engagement Activity 2020
URL https://acmedsci.ac.uk/more/events/the-jean-shanks-lecture-2020
 
Description Keech Hospice Care Masterclass - An Evaluation of Palliative Care's Response to the COVID-19 Pandemic 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This Masterclass speaks to a group of palliative professionals across the Luton, Bedfordshire and Milton Keynes STP. This is a bi-monthly Masterclass aimed at senior professionals, including those working within CCGs, to explore a range of relevant topics.
Year(s) Of Engagement Activity 2023
 
Description Lancaster University Public Lecture Series 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Online public lecture to promote research that Lancaster University academics have been involved in to a wide, general audience.
Year(s) Of Engagement Activity 2020
URL https://www.lancaster.ac.uk/events/public-lectures/
 
Description Open Seminar - Advance Care Planning in the context of COVID 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Open seminar presenting findings from the CovPall study in relation to advance care planning, and related/emerging evidence on this topic
Year(s) Of Engagement Activity 2021
 
Description Oral presentation at the 11th European Association of Palliative Care World Research Congress 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Findings from the first part of this project were presented as oral presentations at the 11th European Association of Palliative Care World Research Congress (October 2020).

Please see Professor Irene J. Higginson's oral presentation on "Role and responses of palliative care during the COVID-19 pandemic and beyond"
https://www.youtube.com/watch?v=NXsfB7jw8tU&list=PLBKtt82NusjCDutufv3EAoASvSmismmH2?dex=1
Year(s) Of Engagement Activity 2020
URL https://www.youtube.com/watch?v=NXsfB7jw8tU&list=PLBKtt82NusjCDutufv3EAoASvSmismmH2&index=1
 
Description Patient and Public Involvement and Engagement (PPIE) Workshop for CovPall Connect 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact The workshop focused on discussing and understanding what information should be collected on every individual to improve palliative, end of life care and bereavement. The findings are feeding into our CovPall-Connect work and influencing recommendations on national minimum dataset to be collected in palliative, end of life care and bereavement.
Year(s) Of Engagement Activity 2021
 
Description Plenary presentation at Oceanic Palliative Care conference (Australia) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Plenary presentation
Year(s) Of Engagement Activity 2021
 
Description Policy brief on the challenges of caring for people dying from covid-19 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Our team wrote a policy brief on the challenges of caring for people dying or seriously ill with COVID-19 and recommended actions in planning for a second pandemic wave (the CovPall Study). This policy brief was shared with key stakeholders in the UK to assist in planning for future pandemics.
Year(s) Of Engagement Activity 2020
 
Description Poster presentation at EAPC conference in October 2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I presented findings from our CovPall study on the impact of covid-19 on palliative and hospice care services at the 11th World Research Congress of the European Association for Palliative Care (EAPC) in October 2020. My presentation was well received and sparked questions and discussions on how the pandemic has affected staff working in palliative and hospice care services. My presentation won an award in its category.
Year(s) Of Engagement Activity 2020
 
Description Presentation at EAPC Congress 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Conference presentation on an aspect of study findings.
Year(s) Of Engagement Activity 2022
 
Description Presentation at King's College Hospital Evidence Update 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Team members presented CovPall findings and plans for CovPall-Connect at King's College Hospital Evidence Update.
Year(s) Of Engagement Activity 2021
 
Description Presentation at National Audit of Care at the End of Life (NACEL) steering group meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof I J Higginson & Dr Mevhibe B Hocaolgu presented an overview of the project and findings on Advance Care Planning/Shortages and Innovations of hospice and palliative care services during the pandemic.
Year(s) Of Engagement Activity 2020
 
Description Presentation at the CSI Seminar series 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Online seminar to present aspect of findings to a mixed audience of researchers, clinicians and policymakers.
Year(s) Of Engagement Activity 2022
 
Description Presentation at the NIHR Consortium for Hospice and Community Research on 18th November 2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This online webinar was organised by NIHR and Charities Consortium for Hospice and Community Research Conference and was targeted at anyone working in the Hospice, Palliative and End of Life Care sector including researchers, hospice staff and charities. Between 51 - 100 people attended this webinar from across the UK and I and Mev presented the findings of our CovPall study. This led to interesting questions and discussions about the impact of the pandemic on our palliative care population as well as those from minority ethnic groups.
Year(s) Of Engagement Activity 2020
 
Description Presentation at the Supportive and Palliative Care Research Virtual Showcase on 23rd February 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This online event was organised by the NIHR Clinical Research Network West Midlands and was targeted at anyone working in the Hospice, Palliative and End of Life Care sector, patients and the public. Between 51 - 100 people attended this event from across the UK and I and Mev presented the findings of our CovPall study. This led to interesting questions and discussions about how volunteers in hospices have been impacted by the covid-19 pandemic.
Year(s) Of Engagement Activity 2021
 
Description Presentation for ECHO call 12/21 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact presentation to palliative care health professionals on ECHO call- this generated discussions and questions on how to manage the palliative care needs of these patients
Year(s) Of Engagement Activity 2021
 
Description Research Impact Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Researchers and clinicians attended a Research Impact Event at the Cicely Saunders Institute on 30/06/21. Researchers and a PPI member gave a presentation on the Covid 19 Pandemic Response. This sparked questions and discussion afterwards.
Year(s) Of Engagement Activity 2021
URL http://www.professionalpalliativehub.com/research/events/%E2%80%98research-impact-covid-19-and-pande...
 
Description Royal College of Physicians of Edinburgh - keynote talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk at RCP Edinburgh on dying well during Covid
Year(s) Of Engagement Activity 2022
 
Description South London ARC Symposium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Team members presented on the CovPall and CovPall-Connect projects at the South London ARC Symposium.
Year(s) Of Engagement Activity 2021
 
Description South London ARC newsletter item 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Project team members submitted a news item for the South London ARC newsletter, which is distributed nationally. The item discussed the ongoing CovPall study and introduced CovPall-Connect.
Year(s) Of Engagement Activity 2021
URL http://www.arc-sl.nihr.ac.uk/research-and-implementation/our-research-areas/palliative-and-end-life-...
 
Description Speaker at KCH What Matters Most Online Conference - 19 to 23 September 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Speak on the topic: Patient-centred outcomes-based healthcare - leading the way at KCH
Year(s) Of Engagement Activity 2022
URL https://www.kingshealthpartners.org/assets/000/004/998/Programme_for_What_Matters_Most_blue_final_or...
 
Description Talk at EAPC 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited talk at EAPC 2022
Year(s) Of Engagement Activity 2022
 
Description Talk at Public Policy Exchange 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Talk at policy conference, data on CovPall presented
Year(s) Of Engagement Activity 2022
 
Description The role of palliative care in the public health response to Covid-19 - CovPall Clinician Event 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact The event highlighted the role of palliative care in the public health response to the Covid-19 pandemic by drawing on the work of the CovPall study. Presentations by team members Professor Irene Higginson and Professor Katherine Sleeman covered topics including:

The challenges of caring for people dying with or from Covid-19
Advance care planning during the pandemic
Service innovations
Inequities in service response
Role of volunteers during the pandemic
Symptom management of patients dying with or from Covid
Impact of the Covid-19 pandemic on staff wellbeing
Year(s) Of Engagement Activity 2021
URL https://www.arc-sl.nihr.ac.uk/events-training/forthcoming-events-training/role-palliative-care-publi...
 
Description Virtual Supportive & Palliative Care Research Showcase organised by NIHR CRN West Midlands 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Prof Irene J Higginson presented CovPall study findings at Virtual Supportive & Palliative Care Research Showcase organised by NIHR CRN West Midlands.
Year(s) Of Engagement Activity 2021
 
Description racial inequality and palliative care keynote lecture at Marie Curie research conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact key note lecture at Marie Curie Research conference. Audience comprised health professionals across all settings. The presentation sparked debate at the conference and on social media
Year(s) Of Engagement Activity 2022