Evaluation of the Rapid Response End of Life Service

Healthwatch Wiltshire carried out an evaluation of the rapid response end of life care service provided by Dorothy House Hospice Care and Prospect Hospice from the perspective of family members whose loved ones were cared for through the service. This service provides urgent care at home (up to 24 hours a day for up to 72-hours) for people at the end of life. They carried out 1:1 interviews with family members and spoke to frontline staff delivering the service.

Relatives of people who had used the service described how grateful and appreciative they were that the service was available to support them and their loved ones.

The service helped people to die in their preferred place of death, at home. The quality of care provided by the hospice healthcare assistants was highly praised by families, who recognised their experience, knowledge and compassion.

While many people found the move ‘on and off’ the service to be seamless, this was not the case for everyone. Not everyone felt that they knew enough about the dying process, and families would have welcomed more support and information. Some people died during the support offered by the service, while others were discharged to other services. Arranging continuing care (following the service) can be difficult and caused delays in discharging people.

The research identified a number of learning points for the service:

• signposting and referral to hospice services is appreciated and helps family members feel things are under control. This is not always happening.
• More contact from specialist nurses during final stages, including at weekends, would be welcome.
• Faster access to symptom relief medication (pain/sickness/secretion control) is needed.
• More information for relatives about what to expect in the final days would be appreciated.
• When a person is discharged from the service, more support is needed in finding alternative paid carers, especially ones with experience of end of life care.