The role of NHS commissioners in assuring the quality of end-of-life care for people who die at home

Why we did this project

Since the start of the Covid-19 pandemic the number of people dying at home has increased significantly. However, financial and staff resources, have not shifted out of hospital at the same rate. There are concerns that the quality of care and support patients, their families and carers receive during the final weeks and months of life may be suffering as a result.

NHS and local authority commissioners play a critical role in developing local services to support end-of-life care, including for people who die at home. However, there is little national data available to support this task or existing research on the impact of the pandemic on commissioners’ work to assure the quality of care for people who die at home.

This project, funded by the Department of Health and Social Care, explored whether and how NHS and local authority commissioners in England measure and assure the quality of the end-of-life care and the support provided to patients who die at home, their families and unpaid carers. As part of this, we were interested in how commissioners identify and address inequalities when they are commissioning services.

What we did

The project involved:

• a review of literature and data sources

• semi-structured interviews with NHS and local authority commissioners as well as key national and regional organisations

• focus groups with family/carers who have supported people at home at the end of life

• a workshop with national and local leaders from across the health and care system to discuss the implications of our findings.