4.3 Article

Charitably funded hospices and the challenges associated with the COVID-19 pandemic: a mixed-methods study (CovPall)

Journal

BMC PALLIATIVE CARE
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12904-022-01070-8

Keywords

Charitably funded Hospice; COVID-19 Pandemic; Mixed-Methods Research; Funding constraints

Funding

  1. Medical Research Council [MR/V012908/1]
  2. National Institute for Health Research, Applied Research Collaboration South London
  3. Cicely Saunders International
  4. NIHR Applied Research Collaboration South London at King's College Hospital National Health Service Foundation Trust
  5. National Institute for Health Research Career Development Fellowship [CDF-2017-10-009]
  6. NIHR Career Development Fellowship [CDF-2018-11-ST2-002]
  7. NIHR ARC SL
  8. National Institutes of Health Research (NIHR) [CDF-2018-11-ST2-002] Funding Source: National Institutes of Health Research (NIHR)

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This study investigated the challenges faced by independent charitably funded hospices in the UK during the COVID-19 pandemic, with key themes including funding vulnerabilities, infection control, and bereavement support provision.
Background Independent charitably funded hospices have been an important element of the UK healthcare response to the COVID-19 pandemic. Hospices usually have different funding streams, procurement processes, and governance arrangements compared to NHS provision, which may affect their experiences during the COVID-19 pandemic. The aim of this study is to understand the challenges faced by charitably funded hospices during the COVID-19 pandemic. Methods Eligible Organisations providing specialist palliative or hospice care completed the online CovPall survey (2020) which explored their response to the COVID-19 pandemic. Eligible organisations were then purposively selected to participate in interviews as part of qualitative case studies (2020-21) to understand challenges in more depth. Free-text responses from the survey were analysed using content analysis and were categorised accordingly. These categorisations were used a priori for a reflexive thematic analysis of interview data. Results 143 UK independent charitably funded hospices completed the online CovPall survey. Five hospices subsequently participated in qualitative case studies (n = 24 staff interviews). Key themes include: vulnerabilities of funding; infection control during patient care; and bereavement support provision. Interviewees discussed the fragility of income due to fundraising events stopping; the difficulties of providing care to COVID-19 and non-COVID-19 patients within relatively small organisations; and challenges with maintaining the quality of bereavement services. Conclusion Some unique care and provision challenges during the COVID-19 pandemic were highlighted by charitably funded hospices. Funding core services charitably and independently may affect their ability to respond to pandemics, or scenarios where resources are unexpectedly insufficient.

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